Peer Seeking Safety App Study - REVISED Phase 2 Eligibility Screen 5/27/17

Thanks for your interest in our study. After you complete the brief questions below, we will get in touch with you if you are eligible.

Yes

Not sure

Yes

Yes

I prefer to do this question by phone (list your phone number or email or best way to reach you)

Yes (this means, "I have bipolar disorder or a psychotic disorder and have current symptoms that are not controlled by medication")

No (this means, "I do not have bipolar disorder or a psychotic disorder, or if I do I am stable and on medication for it)

Unsure (Explain here)

	Yes	No
Have you felt that you ought to cut down on your drinking or drug use?	Have you felt that you ought to cut down on your drinking or drug use? Yes	Have you felt that you ought to cut down on your drinking or drug use? No
Have people annoyed you by criticizing your drinking or drug use?	Have people annoyed you by criticizing your drinking or drug use? Yes	Have people annoyed you by criticizing your drinking or drug use? No
Have you felt bad or guilty about your drinking or drug use?	Have you felt bad or guilty about your drinking or drug use? Yes	Have you felt bad or guilty about your drinking or drug use? No
Have you had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover?	Have you had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover? Yes	Have you had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover? No