Q1-IS ALCOHOL TAKING MORE FROM YOU THAN ITS GIVING YOU.

YES

NO

Q2- DO YOU WANT TO MAKE ALCOHOL SMALL AND IRRELEVANT IN YOUR LIFE

YES

NO

Q3- DO YOU WANT FREEDOM AND GAIN BACK CONTROL OF YOUR DRINKING

YES

NO

Q4- ARE YOU LOCKED INTO A BATTLE FOR SOBRIETY

YES

NO

Q5- HAVE YOU LOST THE CHOICE TO DRINK OR NOT TO DRINK

YES

NO

Q6- HAVE YOU MORE THAN ONCE WANTED TO CUT BACK OR STOP DRINKING AND COULDN'T

YES

NO

Q7- HAVE YOU WANTED A DRINK SO BADLY YOU COULDN'T THINK OF ANYTHING ELSE

YES

NO

Q8- CONTINUED TO DRINK EVEN THOUGH IT WAS CAUSING TROUBLE WITH YOUR FAMILY OR FRIENDS?

YES

NO

Q9- ARE YOU NO LONGER INTERESTED IN ACTIVITIES THAT YOU ONCE ENJOYED IN ORDER TO DRINK?

YES

NO

Q10- ARE YOU DRINKING MUCH MORE THAT YOU ONCE DID TO GET THE SAME EFFECT?

YES

NO

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