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* 1. What is your sex and how old are you?

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* 2. How often do you have a drink containing alcohol?

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* 3. How many alcohol units do you have on a typical day when you are drinking?

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* 4. How many times have you had 5 or more drinks for men or 4 or more drinks for women on a single occasion in the last year?

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* 5. During the last year, how often you were not able to stop drinking once you started?

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* 6. During the last year, how often have you failed to do what was expected of you because of drinking?

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* 7. During the last year, how often have you needed a first drink in the morning to get your self going after a heavy drinking session?

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* 8. During the last year, how often have you had a feeling of guilt or remorse after drinking?

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* 9. During the last year, how often have you been unable to remember what happened the night before because you have been drinking?

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* 10. Have you or someone else been injured because of your drinking or has a relative, friend, doctor or other health worker been concerned about your drinking or suggested you cut down?

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