Which alcoholic beverage do you drink? Beer
Malt Beverage
Mixed Drinks
Shots
Wine

How often do you drink alcohol? --Select One-- Few Time A Year About Once A Month Or So A Few Times A Month 1-3 Days A Week 4 Or More Days A Week

How often do you get drunk (where you know you cant drive legally)? --Select One-- Never Few Time A Year About Once A Month Or So A Few Times A Month 1-3 Days A Week 4 Or More Days A Week

Where do you usually drink? --Select One-- My Place Bar Friends Place House Party Outside

Favorite place to drink? --Select One-- My Place Bar Friends Place House Party Boat Golf Course Sporting Event Concert Park/Beach Festival

Who do you drink with? --Select One-- Usually Myself Myself and Others Equally Usually With Others

When you go out, how do you usually get there? --Select One-- I Usually Just Stay Home I Drive I Walk Someone Drives Me Taxi

Drinking speed: --Select One-- Slow Drinker Moderate Speed Fast

Drinking personality: --Select One-- Emotional Relaxed I Dont Change Sociable Loud Wild I Usually Do Stupid Things

Reason you drink: --Select One-- Because Im Sad Relaxation To Have Fun Nothing Better To Do Relieve Stress Everyone Else Is Its Something Different To Do

Got sick from drinking too much alcohol? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year Yes, Every Other Month Or So

Cried while drinking? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Called in sick to work because of a hangover? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Had marker drawn on your face while passed out? --Select One-- No Yes

Gotten out of a drinking related ticket? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Recieved a drinking related ticket? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Made drunken phone calls that your regret? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Cheated on boyfriend/girlfriend when you were drunk? --Select One-- No Yes

Woke up somewhere not knowing how you got there? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Had open intoxicants in the car? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Done a beer bong? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Done a keg stand? --Select One-- Never Yes, Over A Year Ago Yes, Once This Year Yes, Couple Times This Year

Owned or used a fake ID? --Select One-- No Yes

Are you drinking right now? --Select One-- No Yes

Verification