This checklist guides school counselors, youth workers, and clinicians through a structured process that covers substance use patterns, related risk and protective factors, and observed consequences. Its clear scoring guide categorizes results into Low, Moderate, or High concern, providing actionable next steps—ranging from continued observation to immediate referral for professional assessment. The tool is easy to administer in school, community, or outpatient settings and can serve as a springboard for deeper conversations with youth and caregivers.