Hawaii Counseling and Education Center, Inc. (All information is kept confidential) Symptom Checklist
Hawaii Counseling and Education Center, Inc. Ke Ala La`i Substance Abuse Treatment Program
Hawaii Counseling and Education Center, Inc.
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Client Registration Form
Below is a list of problems people sometimes have. Read each one carefully and circle the number of the response that best describes HOW MUCH THAT PROBLEM HAS DISTRESSED OR BOTHERED YOU DURING THE PAST 7 DAYS INCLUDING TODAY. Do not skip any items. Select only one box for each question.
The information that you give on this form is confidential and is intended to assist me in the course of your therapy or consultation. Some information may be utilized for research purposes. In such cases, any identifying information is removed from the data.