Drinking Habit Survey

 
1. You are:
2. How old are you?
3. How often do you drink?
4. Have you ever tried to cut back?
5. If you’ve ever tried to stop drinking, what was your primary motivation?
6. Do you ever worry alcohol is negatively affecting your life?
7. Have you ever done something you regret while drunk?
8. If you have done something you regretted while drinking, what was it? (Choose all that apply)
9. How often, on average, do hangouts with friends involve drinking?
10. You’re heading out to the bar with a group of friends. How many drinks are you likely to have?
11. How often do you have more than two drinks before you have sex?
12. How does alcohol impact your sex life? (choose all that apply)
13. In the past year, have you ever felt pressure from friends to drink more than you otherwise would?
14. Before a stressful situation (like a blind date or meeting his parents) do you ever have a drink by yourself to loosen up?
15. How likely are you to have a drink when you’re hanging out at home by yourself after work?
16. Aside from any physical symptoms, how do you normally feel after a heavy night of drinking?
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