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1. How often do you have a drink containing alcohol? |
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| Never | Monthly or less | 2-4 times a month | 2-3 times per week | 4+ per week |
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2. How many standard drinks containing alcohol do you have on a typical day when you are drinking? |
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| 1-2 | 3-4 | 5-6 | 7-9 | 10+ |
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3. How often do you have six or more drinks on one occasion? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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4. How often during the last year have you found that you were not able to stop drinking once you had started? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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5. How often during the last year have you failed to do what was normally expected from you because of drinking? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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7. How often during the last year have you had a feeling of guilt or remorse after drinking? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? |
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| Never | Less than monthly | Monthly | Weekly | Daily or almost daily |
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9. Have you or someone else been injured as a result of your drinking? |
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| No | Yes, but not in the last year | Yes, during the last year | ||
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10. Has a relative, friend or doctor, or other health worker been concerned about your drinking or suggested that you should cut down? |
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| No | Yes, but not in the last year | Yes, during the last year | ||