{"id":47,"date":"2022-11-18T16:30:31","date_gmt":"2022-11-18T16:30:31","guid":{"rendered":"https:\/\/www.indianatech.edu\/campuslife\/?page_id=47"},"modified":"2023-01-24T14:48:59","modified_gmt":"2023-01-24T14:48:59","slug":"cage-aid","status":"publish","type":"page","link":"https:\/\/www.indianatech.edu\/wellness-clinic\/additional-mental-health-resources\/cage-aid\/","title":{"rendered":"CAGE-AID"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});<\/script>\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' ><div id='gf_2' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/wellness-clinic\/wp-json\/wp\/v2\/pages\/47\/#gf_2' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_1\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_1\" ><legend class='gfield_label gform-field-label' >How often do you have a drink that contains alcohol?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_1'>\n\t\t\t<div class='gchoice gchoice_2_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='0'  id='choice_2_1_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_1_0' id='label_2_1_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='1'  id='choice_2_1_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_1_1' id='label_2_1_1' class='gform-field-label gform-field-label--type-inline'>Monthly or less<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_1_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='2'  id='choice_2_1_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_1_2' id='label_2_1_2' class='gform-field-label gform-field-label--type-inline'>2-4 times a month<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_1_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='3'  id='choice_2_1_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_1_3' id='label_2_1_3' class='gform-field-label gform-field-label--type-inline'>2-3 times a week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_1_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='4'  id='choice_2_1_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_1_4' id='label_2_1_4' class='gform-field-label gform-field-label--type-inline'>4+ times a week<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_3\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_3\" ><legend class='gfield_label gform-field-label' >How many standard alcoholic drinks do you have on a typical day when you are drinking?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_3'>\n\t\t\t<div class='gchoice gchoice_2_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='0'  id='choice_2_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_3_0' id='label_2_3_0' class='gform-field-label gform-field-label--type-inline'>1-2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='1'  id='choice_2_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_3_1' id='label_2_3_1' class='gform-field-label gform-field-label--type-inline'>3-4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_3_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='2'  id='choice_2_3_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_3_2' id='label_2_3_2' class='gform-field-label gform-field-label--type-inline'>5-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_3_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='3'  id='choice_2_3_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_3_3' id='label_2_3_3' class='gform-field-label gform-field-label--type-inline'>7-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_3_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='4'  id='choice_2_3_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_3_4' id='label_2_3_4' class='gform-field-label gform-field-label--type-inline'>10+<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_4\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_4\" ><legend class='gfield_label gform-field-label' >How often do you have 6 or more standard drinks on one occasion?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_4'>\n\t\t\t<div class='gchoice gchoice_2_4_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='0'  id='choice_2_4_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_4_0' id='label_2_4_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='1'  id='choice_2_4_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_4_1' id='label_2_4_1' class='gform-field-label gform-field-label--type-inline'>Less than monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_4_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='2'  id='choice_2_4_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_4_2' id='label_2_4_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_4_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='3'  id='choice_2_4_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_4_3' id='label_2_4_3' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_4_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='4'  id='choice_2_4_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_4_4' id='label_2_4_4' class='gform-field-label gform-field-label--type-inline'>Daily or almost daily<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_9\" ><legend class='gfield_label gform-field-label' >How often in the last year have you found that you were not able to stop drinking once you had started?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_9'>\n\t\t\t<div class='gchoice gchoice_2_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='0'  id='choice_2_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_9_0' id='label_2_9_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='1'  id='choice_2_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_9_1' id='label_2_9_1' class='gform-field-label gform-field-label--type-inline'>Less than monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='2'  id='choice_2_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_9_2' id='label_2_9_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='3'  id='choice_2_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_9_3' id='label_2_9_3' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='4'  id='choice_2_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_9_4' id='label_2_9_4' class='gform-field-label gform-field-label--type-inline'>Daily or almost daily<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_8\" ><legend class='gfield_label gform-field-label' >How often in the last year have you failed to do what was expected of you because of drinking?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_8'>\n\t\t\t<div class='gchoice gchoice_2_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='0'  id='choice_2_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_0' id='label_2_8_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='1'  id='choice_2_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline'>Less than monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='2'  id='choice_2_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_2' id='label_2_8_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='3'  id='choice_2_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_3' id='label_2_8_3' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='4'  id='choice_2_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_4' id='label_2_8_4' class='gform-field-label gform-field-label--type-inline'>Daily or almost daily<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_7\" ><legend class='gfield_label gform-field-label' >How often in the last year have you needed an alcoholic drink in the morning to get you going?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_7'>\n\t\t\t<div class='gchoice gchoice_2_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='0'  id='choice_2_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_0' id='label_2_7_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='1'  id='choice_2_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_1' id='label_2_7_1' class='gform-field-label gform-field-label--type-inline'>Less than monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='2'  id='choice_2_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_2' id='label_2_7_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='3'  id='choice_2_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_3' id='label_2_7_3' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='4'  id='choice_2_7_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_4' id='label_2_7_4' class='gform-field-label gform-field-label--type-inline'>Daily or almost daily<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_6\" ><legend class='gfield_label gform-field-label' >How often in the last year have you had a feeling of guilt or regret after drinking?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_6'>\n\t\t\t<div class='gchoice gchoice_2_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='0'  id='choice_2_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_0' id='label_2_6_0' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='1'  id='choice_2_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_1' id='label_2_6_1' class='gform-field-label gform-field-label--type-inline'>Less than monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='2'  id='choice_2_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_2' id='label_2_6_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_6_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='3'  id='choice_2_6_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_3' id='label_2_6_3' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_6_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='4'  id='choice_2_6_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_4' id='label_2_6_4' class='gform-field-label gform-field-label--type-inline'>Daily or almost daily<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible immaterial\"  data-field-class=\"immaterial\" data-js-reload=\"field_2_5\" ><legend class='gfield_label gform-field-label' >How often in the last year have you not been able to remember what happened when drinking the night?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_5'>\n\t\t\t<div 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data-field-class=\"immaterial\" data-js-reload=\"field_2_10\" ><legend class='gfield_label gform-field-label' >Have you or someone else been injured as a result of your drinking?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_10'>\n\t\t\t<div class='gchoice gchoice_2_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='0'  id='choice_2_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_10_0' id='label_2_10_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='2'  id='choice_2_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_10_1' id='label_2_10_1' class='gform-field-label gform-field-label--type-inline'>Yes, but not in the last year<\/label>\n\t\t\t<\/div>\n\t\t\t<div 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