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1 Keystone Ave. St 100 Cherry Hill, NJ 08003
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CAGE-AID Questionnaire
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Patient Name
*
Date of Visit
Have you ever felt that you ought to cut down on your drinking or drug use?
Yes
No
Have people annoyed you by criticizing your drinking or drug use?
Yes
No
Have you ever felt bad or guilty about your drinking or drug use?
Yes
No
Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover?
No
Yes
Message
Submit
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