Who will you be taking the assessment for? *

In the past year, have you had times when you ended up drinking more, or longer, than you intended? *

In the past year, have you more than once wanted to cut down or stop drinking, or tried to, but couldn't? *

In the past year, have you felt a craving for alcohol, or a strong desire or urge to drink? *

In the past year, have you spent a lot of time drinking? Or being sick or getting over other after effects? *

Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems? *

In the past year, have you continued to drink even though it was causing trouble with your family or friends? *

In the past year, have you given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink? *

In the past year, have you more than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, using machinery, walking in a dangerous area, or having unsafe sex)? *

In the past year, have you continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout? *

In the past year, have you had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before? *

In the past year, have you found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? *