- Do you feel you are a normal drinker? (Do you drink less than or as much as most other people?) yes no
- Does you wife, husband, parent, or other near relative ever worry or complain about your drinking? yes no
- Do you ever feel guilty about your drinking? yes no
- Do friends or relatives think you're a normal drinker? yes no
- Are you able to stop drinking when you want to? yes no
- Have you ever attended a meeting of Alcholoics Anonymous? yes no
- Has your drinking ever created problems between you and your wife, husband, a parent, or other near relative? yes no
- Have you ever gotten into trouble at work because of your drinking? yes no
- Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking? yes no
- Have you ever gone to anyone for help about your drinking? yes no
- Have you ever been in a hospital because of drinking? yes no
- Have you ever been arrested for drunken driving, driving while intoxicated, or driving under the influence of alcoholic beverages? yes no
- Have you ever been arrested, even for a few hours, because of other drunken behavior? yes no
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