End Dependence Questionnaire and Contact

If you are in a state of crisis or need immediate help for any reason, please call 911. If you feel that you are a danger to yourself, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

If you answered "yes" to any of the questions provided, it is highly recommended that you contact the staff at Hillcrest or another qualified healthcare provider. If you would prefer to be contacted by the staff at Hillcrest we encourage you to leave your contact information in the space provided. Please note that by leaving your information, you consent to allow Hillcrest to use this information to contact you. Any information provided will remain confidential.

If you answered "no" to the questions provided, you are still encouraged to reach out to the staff at Hillcrest or another qualified healthcare provider for a detailed evaluation of your risk for Substance Abuse. This online Substance Abuse assessment is strictly for general information purposes and is not a substitute for an in-person clinical evaluation. This assessment is not a formal diagnostic tool and should not be interpreted as such. Your answers will remain anonymous, if you choose. Please note that by choosing to not leave your information, the staff at Hillcrest will not contact you.

Disclaimer: Hillcrest disclaims any liability, loss, or risk sustained as a consequence, directly or indirectly, of the use and application of these assessments.

Hillcrest Hospital Henryetta offers detox to those who have been struggling with substance abuse.