Typically, clinical evaluations of adolescents’ sexual risk is based on inquiring about past sexual activity, which is limited by not including an adolescent’s cognitive decision making regarding their past sexual decisions. This study describes the novel OPTIONS framework for assessing adolescent sexual risk including three general categories of risk (e.g., primary, secondary, and tertiary risk), which is designed to overcome the limitation of action-based assessment of risk and improve practitioners’ ability to assess the levels of sexual risk. A convenience sample of 201 older adolescents (18-19 years of age) completed an online version of the Relationship Options Survey (ROS), designed to measure the OPTIONS sexual risk assessment. Bivariate correlation among the subscales functioned in the hypothesized manner, with all correlations being statistically significant. Using the OPTIONS model, 22.4% participants were classified as high risk primary, 7.0% participants were classified as high risk secondary, and 27.4% participants were classified as high risk tertiary. The study provided preliminary evidence for OPTIONS model of sexual assessment, which provides a more tailored evaluation by including cognitive decisions regarding an adolescent’s sexual actions.