Alcohol Anonymous Questionnaire

An alcohol anonymous questionnaire is used as an assessment by counselors and doctors to determine whether one is an alcoholic. This questionnaire can also be self administered by individuals who suspect their alcohol practice is over board.

The alcohol anonymous questionnaire helps one to realize their situation early enough and seek treatment.  The questions here also help patients to accept their predicament and hence take steps in reversing the addiction.

An alcohol anonymous questionnaire serves as a good tool for doctors and counselors to determine the extent of addiction hence formulate effective diagnosis and treatment for their patients. It can be used for people in early or advanced addiction stages.

Sample Alcohol Anonymous Questionnaire

Do you abscond your professional duties to drink alcohol? If so, to what extent?________________________________________________________

Has drinking influenced your relationships with your family/friends? Explain how.______________________________________________________
Has drinking had any effect on the happiness in your family or friends?_______________________________________________________

Do you have any particular reason as to why you drink alcohol?______________________________________________________

Do think drinking is affecting your reputation in any way? If so what do you feel about it?______________________________________________________

Have you experienced any financial hurdles as a result of overspending on alcohol?_________________________________________________________

Do you think your drinking has reduced your capacity to care for your family/friends/relatives?_____________________________________________

Has your performance at work decreased as a result of drinking?___________________________________________________________

Do you drink alcohol to forget your problems?_________________________________________________________

Have you been to a hospital or seen a counselor as a result of over drinking?__________________________________________________________

Have you ever experienced a complete memory lapse as a result of drinking?______________________________________________________
Does alcohol help you re build your self confidence? ________________________________________________________

Category: Health Questionnaire

Comments are closed.

Copy Protected by Chetan's WP-Copyprotect.