Alcohol Questionnaire for Adults

Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.

Personal Details

Title
Date of Birth
Address
Email

Alcohol Consumption

This is one unit of alcohol:

  • Half pint of regular Beer/Lager/Cider
  • 1 small glass of wine
  • 1 single measure of spirits
  • 1 single measure of aperitifs
  • 1 small glass of sherry

Each of these is more than one unit:

  • Pint of regular Beer/Lager/Cider (2 Units)
  • Pint of Premium Beer/Lager/Cider (3 Units)
  • Alcopop or can/bottle of regular Lager (1.5 Units)
  • Can of Premium Lager/Strong Beer (2 Units)
  • Can of super strength lager (4 Units)
  • Glass of wine (2 Units)
  • Bottle of wine (9 Units)
How often do you have a drink containing alcohol?
How many units of alcohol do you drink on a typical day when you are drinking?
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?