Alcohol Questionnaire

Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.

Name
DD slash MM slash YYYY

Alcohol Units

2 units = 1 pint beer or 1 glass of wine (175mls),

1 unit = single measure of spirits,

1.5 units = alcopop or a can of Lager,

9 units = 1 bottle of wine.

If your score is above 8, please make an appointment to discuss your alcohol use or visit www.nhs.uk/live-well/alcohol-advice/alcohol-support/.