Fill out the quiz below to get an assessment if you or someone you care about is suffering from a dual diagnosis & co-occurring disorder.

First Name

Last Name

Phone *

Email *

By checking this box, I consent to Your Well Being contacting me by SMS to respond to my above inquiry on services and for future marketing messages and offers. We will not sell, distribute, or lease your personal information.

Has a medical doctor given you a diagnosis for anxiety in the last 6-12 months? *

Yes

Have you been taking medications for anxiety, depression, bipolar disorder, or Post Traumatic Stress Disorder? *

Yes

Have you been given a diagnosis of depression recently or been taking antidepressants? *

Yes

Has a medical doctor ever diagnosed you with bipolar disorder or (PTSD) Post Traumatic Stress Disorder? *

Yes

Do you sleep more than 9 hours a night because there's no real reason to get up in the morning? *

Yes

Is it difficult for you to focus on whatever you have to do at work or at home? *

Yes

Are you an excessive worrier? *

Yes

Are you afraid you will have a panic attack suddenly or plan your schedule to avoid situations where it would be embarrassing if you had a panic attack? *

Yes

Have you ever been sexually abused, or witnessed violence or death of someone close to you? *

Yes

Are there 'rituals' you have to do every day; otherwise, things are not right in life? *

Yes

Do you entertain thoughts of committing suicide? *

Yes

Do you have a phobia such as a fear of leaving your house, people, crowds, flying, animals, snakes, bridges, or other things, which prevent you from doing certain activities or going places? *

Yes