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Demo clinic
Multi Specialty Clinic
Alcohol consumption review
Alcohol consumption review
Section
Alcohol consumption
This is one unit of alcohol:
And each one of these, is more than one unit:
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
Further questions
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
How often during the last year have you failed to do what was normally expected from you because of your drinking?
*
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session?
*
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
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
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
Have you or somebody else been injured as a result of your drinking?
*
No
Yes, but not in the last year
Yes, during the last year
Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?
*
No
Yes, but not in the last year
Yes, during the last year
Mood
How are you feeling?
On a scale of 1 being “sad, depressed or down”, 5 being “not happy or sad” or 10 being “happy, awesome, great”
1
2
3
4
5
6
7
8
9
10
Terms and conditions
*
I confirm that this is not an emergency and understand the surgery cannot help while it is closed. If I need help right now, I will use the NHS 111 service. In an emergency, I will call 999 or go to A&E.
Submit
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