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1. Please enter your email address:

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2. How Often Do You Have A Drink Containing Alcohol?

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

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4. How often do you have six or more drinks on one occasion?

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5. How often during the last year have you found that you were not able to stop drinking once you had started?

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6. How often during the last year have you failed to do what was normally expected of you because of drinking?

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7. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

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8. How often during the last year have you had a feeling of guilt or remorse after drinking?

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9. How often during the last year have you been unable to remember what happened the night before because of your drinking?

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10. Have you or someone else been injured because of your drinking?

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11. Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down?

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