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DATE COMPLETED (dd/mm/yyyy) TOOL DRUG HISTORY Comments: QUESTIONNAIRE ADVERSE CONSEQUENCES Comments: SOCRATES Alcohol Drug* Drug* Comments: Alcohol Drug* Drug* Comments: Recognition Ambivalence Taking Steps DTCQ-8 Unpleasant Emotions Physical Discomfort Pleasant Emotions Testing Personal Control Urges/Temptations Conflict with Others Social Pressure Pleasant Times List: (If applicable) Drug #1 Drug #2 Global Score TREATMENT Internal Positive /28.

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