Dear Client:  We are glad you are here to visit us. You can use the links below to fill out forms before you visit us in the office. Please read the instructions below carefully.  If you have any questions, don’t hesitate to call in for assistance or email us at information@addsiowa.org.

Here for an evaluation? Please complete forms 1 – 5.  Are you getting admitted today?  Please complete forms 1-6.

Coronavirus (COVID-19) Screener – Required for all evaluations, and all admissions until further notice.

1. Additional Assessment

2. ACEs Questionnaire

3. Patient Health Questionnaire – 9 (evaluations only)

4. Alcohol Use Disorder Identification Test

5. Drug Abuse Screening Test

6. Activities of Daily Living

ADDS Release of Information

ADDS Criminal Justice Release of Information 

Department of Corrections Referral Form for Substance Use Evaluations

Initial Client Information Form

PHQ-9 Update (use if your counselor asked you to complete this)

The below two forms are required for all residential admissions

*Download tobacco / nicotine and 60 Day acknowledgement here (Online form submission)

*Download tobacco / nicotine and 60 Day acknowledgement here (Paper form download)

*Supports for medical needs (Paper form download)

*Supports for medical needs (Online form submission)