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Question 1 of 4

How often do you have 6 or more drinks on one occasion?

Never Less Than Monthly Monthly Weekly Daily or Almost Daily

Question 2 of 4

How often during the last year have you been unable to remember what happened the night before because you had been drinking?

Never Less Than Monthly Monthly Weekly Daily or Almost Daily

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Question 3 of 4

How often during the last year have you failed to do what was normally expected of you because of your drinking?

Never Less Than Monthly Monthly Weekly Daily or Almost Daily

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Question 4 of 4

Has a relative or friend, a doctor or other health worker been concerned about your drinking or suggested you cut down?

No Yes, but not in the last year Yes in the last year

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