Please be advised that this screening tool is copyrighted and the sole property of Peachstate Psychiatric Services, Inc. Any person or agencies discovered using this proprietary tool without written permission, will be prosecuted to the maximum extent of the law. We advise all participants that this is not a formal diagnostic tool. No DSM-IV diagnosis can be based solely with the use of this tool. If you are a positive screen, we would like to serve you in our facility. However, if you have a POTENTIAL positive screen and choose NOT to use our clinical services, we STRONGLY recommend that you seek professional behavioral health care at the facility or provider of your choice.

Before proceeding with this screening tool, please click here to read the entire disclaimer.


1. Are you feeling more tired lately?
Yes No

2. Have you been more sad than usual lately?
Yes No

3. Are you currently drinking more than you have in the past?
Yes No

4. Does everything get on your nerves?
Yes No

5. Have you not been feeling like yourself lately?
Yes No