Test Yes Forms

Self-Test for Alcohol Addiction

1. HOW OFTEN DO YOU HAVE A DRINK CONTAINING ALCOHOL?
2. HOW MANY ALCOHOLIC DRINKS DO YOU HAVE ON A TYPICAL DAY WHEN YOU ARE DRINKING?
3. HOW OFTEN DO YOU HAVE 6 OR MORE DRINKS ON ONE OCCASION?
4. HOW OFTEN DURING THE PAST YEAR HAVE YOU FOUND THAT YOU DRANK MORE OR FOR A LONGER TIME THAN YOU INTENDED?
5. HOW OFTEN DURING THE PAST YEAR HAVE YOU FAILED TO DO WHAT WAS NORMALLY EXPECTED OF YOU BECAUSE OF YOUR DRINKING?
6. HOW OFTEN DURING THE PAST YEAR HAVE YOU HAD A DRINK IN THE MORNING TO GET YOURSELF GOING AFTER A HEAVY DRINKING SESSION?
7. HOW OFTEN DURING THE PAST YEAR HAVE YOU FELT GUILTY OR REMORSEFUL AFTER DRINKING?
8. HOW OFTEN DURING THE PAST YEAR HAVE YOU BEEN UNABLE TO REMEMBER WHAT HAPPENED THE NIGHT BEFORE BECAUSE OF YOUR DRINKING?
9. HAVE YOU OR ANYONE ELSE BEEN INJURED AS A RESULT OF YOUR DRINKING?
10. HAS A RELATIVE, FRIEND, DOCTOR, OR HEALTH CARE WORKER BEEN CONCERNED ABOUT YOUR DRINKING, OR SUGGESTED THAT YOU CUT DOWN?

Number of "Yes"

Yes: 0

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