| Do you feel you are a normal drinker?(By normal we mean you drink
less than or as much as most other people.)
Yes
No |
| Does your wife, husband, a parent, or other near relatives ever
worry or complain about your drinking?
Yes
No |
| Do friends or relatives think you are a normal drinker?
Yes
No |
| Do you ever feel guilty about your drinking?
Yes
No |
| Have you ever attended a meeting of Alcoholics Anonymous?
Yes
No |
| Are you able to stop drinking when you want to?
Yes
No |
| Have you ever gone to anyone for help about your drinking?
Yes
No |
| Have you ever gotten into trouble at work because of drinking?
Yes
No |
| Has drinking ever created problems between you and your wife,
husband, or other near relatives?
Yes
No |
| Have you ever neglected your obligations, your family, or your
work for two or more days in a row because you were drinking?
Yes
No |
| Have you ever been in a hospital because of drinking?
Yes
No |
| Have you ever been arrested for drunk driving, driving while
intoxicated, or driving under the influence of alcoholic beverages?
Yes
No |
| Have you ever been arrested, even for a few hours, because of
other drunk behavior?
Yes
No |