The Alcohol Use Disorders Identification Test: Self-Report Version
Because alcohol use can affect your health and can interfere with certain medications and treatments, it is important to ask you some questions about your use of alcohol. Select an answer for each question that best describes your experience. Please be as honest as possible. 
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1. How often do you have a drink containing alcohol?
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2. How many drinks containing alcohol do you have on a typical day when you are drinking? *
3. How often do you have six or more drinks on one occasion? *
4. How often during the last year have you found that you were not able to stop drinking once you had started? *
5. How often during the last year have you failed to do what was normally expected of you because of drinking? *
6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? *
7. How often during the last year have you had a feeling of guilt or remorse after drinking? *
8. How often during the last year have you been unable to remember what happened the night before because of your drinking? *
9. Have you or someone else been injured because of your drinking? *
10. Has a relative, friend, doctor, or other health worker been concerned about your drinking or suggested you cut down? *
Name: (First and Last) *
A copy of your responses will be emailed to the address you provided.
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