Select the statements that best reflect what you have been experiencing over the last few months. Please be honest with your answers. This inventory is confidential and secure; any information collected will be used for the express purpose of contacting you regarding the submission of this form only.
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If you checked statement 10, seek help immediately, regardless of the other statements you checked.
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If you checked two or more of these statements, you should schedule a free behavioral health screening at Lifeways.
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If you checked less than two statements but still feel your ability to function in life is impaired, you should schedule a free behavioral health screening at Lifeways.
This tool was developed to help you become more familiar with what you or someone you care about may be experiencing. If it can help explain your feelings, share this inventory with someone who cares about you or with a behavioral health professional.
It's important to note that only a health care professional can diagnose a behavioral health disorder.
To begin receiving the care that you need you can contact Lifeways by calling us toll free at our Malheur location at
(800) 995-9169, by calling us toll free at our Umatilla location at
(866) 343-4473, or by providing some simple contact information below. All information collected is confidential and secure.
