Parents-quiz

Have you found your child using/under the influence of mood altering substances? ( THC, Alcohol, Cocaine, Heroin, Methamphetamine, Xanax ) *

Yes No

Have you noticed your child is showing a decrease in interests that they used to enjoy? (After school clubs, sports, hobbies, instruments) *

Yes No

Have you noticed an increase in isolation in your child’s behavior? (Sleeping in excess, spending more time alone, spending time in their room) *

Yes No

Have you noticed any distinct change in mood in your child? (Emotional Outbursts, increase crying/yelling, anger/yelling)*

Yes No

Have you noticed a decrease in your children’s grades at school? (Going from A’s to C’s, C’s to F’s (typically a two grade bump) *

Yes No

Name*

First Name

Last Name

Email*

We will privately and securely send you your quiz results.

Phone*