Q 1. Have you ever decided to stop drinking for a week or so but only lasted for a couple of days?

Yes    No

Q 2. Do you wish people would mind their own business about your drinking - stop telling you to cut down?

Yes    No

Q 3. Do you regularly switch from one kind of drink to another in the hope that this will keep you from getting drunk?

Yes    No

Q 4. Have you often had to have a drink first thing in the morning?

Yes    No

Q 5. Do you envy people who can drink without getting into trouble?

Yes    No

Q 6. Have you had a number of problems connected with drinking during the past year?

Yes    No

Q 7. Has your drinking caused trouble at home?

Yes    No

Q 8. Do you ever try to sneak extra drinks at a party because you do not get enough?

Yes    No

Q 9. Do you tell yourself you can stop drinking any time you want to, even though you keep getting drunk when you don't mean to?

Yes    No

Q 10. Have you regularly missed days off work or college because of drinking?

Yes    No

Q 11. Do you often have blackouts?

Yes    No