Questionnaire
Email address *
What state do you reside in? *
Your answer
Do you feel drinking is contributing to some weight gain and you would like to lose some weight by cutting back? *
Do you see yourself as facing some limitations in your social life because you feel a need to avoid other people who drink, or avoid places such as parties, events, weddings, restaurants, dates, brunches or bars, and you would like to eliminate these restrictions? *
Do you want to improve one or more relationships by cutting back or stopping drinking? This could be a social relationship or something more formal, such as an employment relationship. *
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