Beer Wine Spirits 200ml Glass (4%) = 0.6 standard drinks 500ml Glass (4%) = 1.6 standard drinks 330ml Can (4%) = 1.0 standard drinks 440ml Can (4.2%) = 1.5 standard drinks 330ml Bottle (5%) = 1.3 standard drinks 330ml Bottle (Light) (2.5%) = 0.7 standard drinks Jug = 4.0 standard drinks 100ml Glass (12.5%) = 1.0 standard drinks 750ml Bottle (13%) = 7.7 standard drinks 750ml Bottle (Sparkling - 12%) = 7.1 standard drinks 750ml Bottle (14%) = 8.3 standard drinks Cask = 30 standard drinks 275ml RTD (5%) = 1.1 standard drinks 335ml RTD (8%) = 2.1 standard drinks 50ml Mini Bottle (37%) = 1.5 standard drinks 30ml shot (40%) = 1.0 standard drinks 50ml tumbler (37.5%) = 1.5 standard drinks 375ml Flask (37.5%) = 11 standard drinks 500ml Bottle (37.5%) = 15 standard drinks 1 litre Bottle (47%) = 37 standard drinks 1.125 litre Bottle (45%) = 40 standard drinks

Advice given today: *

Yes No

Add classification:

Not Required Non Drinker Within Guideline Exceeds Guideline

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What sort of drinker are you?

You can download a copy of the DrinkCheck questionnaire to complete offline.

Section A:

1. How often do you have a drink containing alcohol?
Never	Monthly or less	2-4 times a month	2-3 times per week	4+ per week
2. How many standard drinks containing alcohol do you have on a typical day when you are drinking?
1-2	3-4	5-6	7-9	10+
3. How often do you have six or more drinks on one occasion?
Never	Less than monthly	Monthly	Weekly	Daily or almost daily

Section B:

4. 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
5. 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
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?
Never	Less than monthly	Monthly	Weekly	Daily or almost daily

Section C:

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
8. 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

9. Have you or someone else been injured as a result of your drinking?
No	Yes, but not in the last year	Yes, during the last year
10. Has a relative, friend or doctor, or other health worker been concerned about your drinking or suggested that you should cut down?
No	Yes, but not in the last year	Yes, during the last year

Total:

Patient referral:

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Claim for brief assessment given today:
Claim for counselling given today:
Claim for follow-up provided today:	Claim for Follow-Up
Consent:	Patient consents to share this information with the PHO

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* = Mandatory

ABC Alcohol Resources

For Clinicians:

• CAGE Alcohol Dependence Questionnaire
• Alcohol Advisory Council
• Brief Lifestyle Intervention (WRPHO)
• SACS Information (Substance and choice scale)
• Alcohol & Drug Helpline

For Patients:

• How to Ease up on the Drink
• Is your drinking OK?
• Body effects info
• New Zealand Drug foundation (NZDF)

Is your drinking OK?

This advice is designed to help you make an informed choice and help keep your risk of alcohol-related accidents, injuries, diseases and death low.

Low-risk is not, however, no-risk. Even when drinking within the low-risk limits, a range of factors can affect your level of risk including if you drink too quickly, your body type or genetic makeup, your gender, existing health problems, and if you are young or an older person.

Your drinking

Tips for low-risk drinking

It is possible to drink at a level that is less risky, while still having fun. There are a number of things you can do to make sure you stay within low risk levels and don't get to a stage where you are no longer capable of controlling your drinking.

These include:

Know what a standard drink is Keep track of how much you drink - daily and weekly Set limits for yourself and stick to them Start with non-alcoholic drinks and alternate with alcoholic drinks Drink slowly

Try drinks with a lower alcohol content Eat before or while you are drinking Never drink and drive Be a responsible host Talk to your kids about alcohol.

If you or someone you know needs support and treatment to reduce their alcohol intake, call the Alcohol Drug Helpline on 0800 787 797 for free and confidential advice.