Emotional Wellness Questonnaire

Drinking alcohol can affect your health. This is especially important if you take certain medications. We want to help you stay healthy and lower your risk for the problems that can be caused by drinking.

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These questions are about your drinking habits. We’ve listed the serving size of one drink below.

How often do you consume alcoholic beverages?

How many drinks containing alcohol do you have on a typical day when you are drinking?

How often do you have four or more drinks on one occasion?

How often during the last year have you...

...found that you were not able to stop drinking once you had started?

...failed to do what was normally expected from you because of drinking?

...needed a first drink in the morning to get yourself going after heavy drinking?

...had a feeling of guilt or remorse after drinking?

...been unable to remember what happened the night before because you had been drinking?

One drink of alcohol is equal to:

  • 12 ounces of beer or wine cooler

  • 1.5 ounces of 80 proof liquor

  • 5 ounces of wine

  • 4 ounces of brandy, liqueur or aperitif

Have you or someone else been injured as a result of your drinking?

Has a relative, friend, doctor or other health worker been concerned about your drinking or suggested you cut down?