Microsoft Word - Keays Medical Group
OPIOID RISK TOOL. Mark each Item Score Item Score box that applies If Female If Male. Female Male. Family History of Substance Abuse. Alcohol 13. Illegal Drugs 23. Prescription Drugs 44. Personal History of Substance Abuse. Alcohol 33. Illegal Drugs 44. Prescription Drugs 55. Age (Mark box if 16 – 45)11. History of Preadolescent Sexual Abuse ... ................
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