Alcohol Risks (AUDIT)

How much do you drink?

1. How often do you have beer, wine or other drinks containing alcohol? never monthly or less 2-4 times a month 2-3 times a week 4 times a week or more Please choose one.

2. How many drinks containing alcohol do you have on a typical day when you are drinking? 1-2 drinks 3-4 drinks 5-6 drinks 7-9 drinks 10 drinks or more Please choose one.

3. How often do you have 6 or more drinks on an occasion when you are drinking? never less than monthly monthly weekly daily or almost daily Please choose one.

Had a long night?

4. How often during the past year have you found that you were not able to stop drinking once you had started? never less than monthly monthly weekly daily or almost daily Please choose one.

Something didn't get done?

5. How often during the past year have you failed to do what was normally expected of you because of drinking? never less than monthly monthly weekly daily or almost daily Please choose one.

Needed an eye-opener?

6. How often during the past year have you needed a first drink in the morning to get yourself going after a heavy drinking session? never less than monthly monthly weekly daily or almost daily Please choose one.

Any regrets?

7. How often during the last year have you had a feeling of guilt or remorse after drinking? never less than monthly monthly weekly daily or almost daily Please choose one.

Blacked out?

8. How often during the past year have you been unable to remember what happened the night before because you had been drinking? never less than monthly monthly weekly daily or almost daily Please choose one.

Injured yourself or others?

9. Have you or has someone else been injured as a result of your drinking? no yes, but not in the past year yes, during the past year Please choose one.

Got told off?

10. Has a relative, friend, or a doctor or other health care worker been concerned about your drinking or suggested you cut down? never yes, but not in the past year yes, during the past year Please choose one.

11. Sex Man Woman Please choose one.

12. Age 15 or less 16 - 17 18 - 24 25 - 30 31 - 40 41 - 50 51 - 64 65 or more Please choose one.

13. Whom are you testing? yourself partner child relative client Please choose one.