Alcohol Screening Quiz
To correctly answer some of these questions you need to know the definition of a drink. For this test one drink is: One can of beer (12 oz or approx 330 ml of 5% alcohol), or One glass of wine (5 oz or approx 140 ml of 12% alcohol), or One shot of liquor (1.5 oz or approx 40 ml of 40% alcohol).
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indicates required fields
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How often do you have a drink containing alcohol?:
Never (score 0)
Monthly or Less (score 1)
2-4 times a month (score 2)
2-3 times a week (score 3)
4 or more times a week (score 4)
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Typically how many drinks in one day?:
1 or 2 (0)
3 or 4 (1
5 or 6 (2)
7-9 (3)
10 or more (4)
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How often you have 6 or more drinks on 1 occasion?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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How often do you drink more/longer than you plan?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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How often are others disappointed by you drinking?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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How often to you dring in the AM to get going?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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How often do you feel guilty for drinking?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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How often do you forget the day before when drink?:
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
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Has anyone else been hurt from you drinking?:
No (0)
Yes, but not in the past year (2)
Yes, during the past year (4)
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Has anyone ever been concerned by your drinking?:
No (0)
Yes, but not in the past year (2)
Yes, during the past year (4)
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Has anyone ever suggested you cut down drinking?:
No (0)
Yes, but not in the past year (2)
Yes, during the past year (4)
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How did you score?:
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Name:
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E-mail:
Address:
Phone:
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