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Follow up
Follow Up
Hidden
ARC Number
Have you made progress towards your goals?
*
Yes
Somewhat
No
Not Applicable
Are you currently employed?
*
Full-time (35+ hrs/wk, includes armed forces)
Part-time (less than 35 hours a week)
Unemployed, looking for work in the past 30 days, or layoff from job
Not in the labor force
Are you currently continuing your education?
*
Yes- Enrolled Full-time
Yes- Enrolled Part-time
No- Have Applied
No- Have not Applied
No- Continuing my education was never a goal
Highest level of education attained
*
Less than high school
High school diploma
GED
Some college, but no degree
Associate's degree
Vocational degree
Bachelor's degree
Satisfaction
Very dissatisfied
Somewhat dissatisfied
Neutral
Somewhat Satisfied
Very Satisfied
If applicable, please rate your level of satisfaction with your employment status
If applicable, please rate your level of satisfaction with your education status
How many times have you visited an Emergency Room in the past 6 months (if any)?
*
How many times have you been arrested in the past 6 months (if any)?
*
Assessment of Recovery Capital
I am currently completely abstinent from substance use
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel I am in control of my substance use
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have had no thoughts about reoccurrence
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have had no recent periods of substance intoxication
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
There are more important things to me in life than using substances
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am able to concentrate when I need to
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am coping with the stresses in my life
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am happy with my appearance
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
In general I am happy with my life
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
What happens to me in the future mostly depends on me
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I cope well with everyday tasks
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel physically well enough to work
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have enough energy to complete the tasks I set myself
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have no problems getting around
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I sleep well most nights
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am proud of the community I live in and feel part of it
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
It is important for me to contribute to society and or be in involved in activities that contribute to my community
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
It is important for me to do what I can to help other people
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
It is important for me that I make a contribution to society
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My personal identity does not revolve around drug use or drinking
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am happy with my personal life
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am satisfied with my involvement with my family
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I get lots of support from friends
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I get the emotional help and support I need from my family
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have a special person that I can share my joys and sorrows with
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am actively involved in leisure and sport activities
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am actively engaged in efforts to improve myself (training, education and/or self-awareness)
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I engage in activities that I find enjoyable and fulfilling
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have access to opportunities for career development (job opportunities, volunteering or apprenticeships)
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I regard my life as challenging and fulfilling without the need for using drugs or alcohol
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am proud of my home
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am free of threat or harm when I am at home
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel safe and protected where I live
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel that I am free to shape my own destiny
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My living space has helped to drive my recovery journey
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am free from worries about money
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have the personal resources I need to make decisions about my future
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have the privacy I need
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I make sure I do nothing that hurts or damages other people
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I take full responsibility for my actions
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am happy dealing with a range of professional people
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I do not let other people down
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I eat regularly and have a balanced diet
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I look after my health and wellbeing
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I meet all of my obligations promptly
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Having a sense of purpose in life is important to my recovery journey
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am making good progress on my recovery journey
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I engage in activities and events that support my recovery
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have a network of people I can rely on to support my recovery
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
When I think of the future I feel optimistic
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
