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ALCOHOL CONSUMPTION REVIEW
Full name
*
Phone number
*
Date of birth
*
E-mail
*
This is one unit of alcohol…
…and each of these is more than one unit
How many units of alcohol do you drink in a typical week?
*
Scoring system
Your score
How often do you have a drink containing alcohol?
Never
Monthly or less
2 - 4 times per month
2 - 3 times per week
4+ times per week
How many units of alcohol do you drink on a typical day when you are drinking?
1 - 2
3 - 4
5 - 6
7 - 9
10+
How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year?
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
TOTAL SCORE:
0