Are you an alcoholic?


This brief test is not meant to provide definite clinical evaluations, but can be a
good indicator of a potential problem.
Answer the following questions honestly to obtain the best results.



1. Do you drink alone? YESNO
2. Does your drinking cause you to lose time from work? YESNO
3. Do you have job problems due to your drinking? YESNO
4. Do you hide your alcohol consumption or the actual alcohol? YESNO
5. Is your drinking making your home life unhappy? YESNO
6. Do you forget things while or after drinking? YESNO
7. Do you drink because you are shy with others? YESNO
8. Do you have health problems caused by your drinking? YESNO
9. Have you ever felt remorse after drinking? YESNO
10. Do you use alcohol to make you relax? YESNO
11. Have you had financial difficulties as a result of drinking? YESNO
12. Have you tried to cut down or quit drinking? YESNO
13. Have you had legal problems due to drinking? YESNO
14. Do you crave a drink at a definite time each day? YESNO
15. Do you want a drink the next morning? YESNO
16. Does drinking cause you to have problems sleeping? YESNO
17. Do you drink to escape from worries or troubles? YESNO
18. Do you feel you have a drinking problem? YESNO
If you answer YES to three or more questions it may be a signal that an abuse/dependency problem may exist.
Call Penfield at (706) 453-7929 for a free confidential screening
     

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