You can use this form to create a somewhat more customized worksheet with questions for working your 12 step program for specific addictions. If you select the type of addictive behavior(s) that you have engaged in and the step number you are working on, you will get a set of questions that should be more specific to your specific program.

Currently, addiction specific questions are only available for certain combinations of step/addiction. See the bottom of this page for the number of questions for a given step/addictive behavior combination. We plan to add additional questions over time, so please check back later if you would like additional questions.

We also have forums for discussing the worksheets.


Type of Addictive Behaviors

  General Addictive Behaviors
  Alcohol Related
  Narcotic Drug Related
  Prescription Drug Related
  Overeating Related
  Bulimia or Anorexia Related
  Overspending Related
  Gambling Related
  Pornography Related
  Sexual Relations Related
  Self-Harm Related
  Codependency Related

Step Number

  Step 1
  Step 2
  Step 3
  Step 4 (General)
  Step 4 (Childhood)
  Step 4 (Adolescence)
  Step 4 (Adult)
  Step 5
  Step 6
  Step 7
  Step 8
  Step 9
  Step 10
  Step 11
  Step 12

Output Format

  Plain Text
  HTML
  CSV (Excel)

Number of Questions

The table below shows the number of questions that are output by the form above, grouped by addictive behavior and step number. For Step 4 questions we use the following abbreviations:

  • 4G - Step 4 Questions in General
  • 4C - Step 4 Questions about Childhood
  • 4T - Step 4 Questions about Teenage or Adolescent years
  • 4A - Step 4 Questions about Adulthood

For example, for General Addictive Behaviors for Step 1, there are 20 questions that are output from the above form.

Step Number 1 2 3 4G 4C 4T 4A 5 6 7 8 9 10 11 12
General Addictive Behaviors 20 8 11 25 44 50 128 9 14 14 9 13 5 8 7
Alcohol Related 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Narcotic Drug Related 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Prescription Drug Related 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Overeating Related 1 0 0 27 0 0 0 0 0 0 0 0 0 0 0
Bulimia or Anorexia Related 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Overspending Related 2 0 0 25 0 0 0 0 0 0 0 0 0 0 0
Gambling Related 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pornography Related 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sexual Relations Related 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Self-Harm Related 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Codependency Related 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0