27799668__HEADSSS_Questions__Long_Form___Short_Form
[Subject] Home [Long Form] Where do you live? Who do you live with? Do you share a bedroom? With whom? How do you get along with the people you live with? How much time do you spend at home? What do you and your family argue about? Can you go to your parents/guardian with problems? Have you ever run away from home? [Short Form] 
How are things at home? Who lives at home? How do you get along with the other people in your house?
Adolescent Health Care - Sample HEADSSS Questions (Long Form)
Short Form