Gender
Male
Female
How often do you have a drink containing alcohol?
Never
Monthly or less
2-4 times per month
2-3 times per week
4 or more times per week
How many drinks do you have on a typical day when you are drinking?
None
1 or 2
3 or 4
5 or 6
7-9
10 or more
How often do you have 6 or more drinks on one occasion?
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
How often during the last 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
How often during the last year have you failed to do what was normally expected from you because of drinking?
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
How often during the last 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
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
How often during the last 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
Have you or someone else been injured as a result of your drinking?
Never
Yes, but not in the last year
Yes, during the last year
Has a relative or friend, or a doctor or other health worker been concerned about your drinking or suggested you cut down?
Never
Yes, but not in the last year
Yes, during the last year
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