• Does the patient have a place to live?
• Is it satisfactory?
• Does it place the patient at risk for cocaine use?
• Does the patient have a phone?
• Are there utilities in service?
• Is any type of housing assistance needed?

Employment

• What is the patient's employmeny status?
• Is this employmeny satisfactory?
• Is cocaine use a risk on the job?
• What services can be used to improve the situation?

Financial

• Is the patient in trouble financially?
• Is the patient in need of financial counseling?
• What financial services are needed?

Education

• Would the individual benefit from additional education?
• Is the patient interested in obtaining more education?
• re the patient's expectations realistic?

Health

• Does the patient have adequate health care?
• Is the patient or the family in need of health services?
• What health services could the patient use?

Legal

• Is the patient in need of legal assistance?
• What type of legal services would be helpful?

Childcare

• Does the patient need childcare services?
• What type of childcare would be helpful?

Transportation

• Does the patient need transportation services?
• What type of transportation would be helpful?

Assessment

List the areas/and or services that would benefit the patient.