Personal Alcohol Profile 23 1. Felt guilty about your drinking?(Required) YES NO 2.Cut a class or missed work after having several drinks?(Required) YES NO 3. Heard anyone close to you complain about your drinking or suggest that you cut down on your drinking?(Required) YES NO 4. Gotten "high" on alcohol before going out on a date?(Required) YES NO 5. Passed out from drinking while on a date or out with friends?(Required) YES NO 6.Gotten into conflicts with your friends or acquaintances after drinking?(Required) YES NO 7. Drank and stayed at home instead of going out to be with others?(Required) YES NO 8.Lied to friends about your drinking?(Required) YES NO 9. Acted more quarrelsome or angry after drinking?(Required) YES NO 10. Had a difficult time being with friends without drinking?(Required) YES NO 11. Had bad abdominal pain the morning after drinking?(Required) YES NO 12. Found that you could not remember the night before when you were drinking?(Required) YES NO 13. Missed morning classes are went to work late because you had been drinking?(Required) YES NO 14. Drank when you felt lonely are depressed?(Required) YES NO 15. Become more depressed when drinking?(Required) YES NO 16. Drank after blowing an exam or after other disappointments?(Required) YES NO 17. Been scared by your reaction to alcohol?(Required) YES NO 18. Run out of money because you spent too much on alcohol?(Required) YES NO 19. Gotten into trouble with the police or campus officials because of your behavior after drinking?(Required) YES NO 20 Spent more money on alcohol than you think you should have?(Required) YES NO 21. Damaged personal or school property after drinking?(Required) YES NO 22. Driven a car when you know you have had too much to drink?(Required) YES NO 23. Usually gulped the first two or three drinks?(Required) YES NO 24. Chosen not to attend a social activity because there would be no alcohol?(Required) YES NO 25. Increased the amount of alcohol that you used?(Required) YES NO 26. Found that you are using more and enjoying it less?(Required) YES NO 27. Drank in order to forget or feel better about problems ?(Required) YES NO 28. Thought that you might have a drinking problem?(Required) YES NO 29. Engaged in sex after drinking that you were later sorry for or embarrassed about?(Required) YES NO 30. Has answering the above questions caused you to think any differently about your drinking?(Required) YES NO PART II1. Do either of your parents have a drinking problem?(Required) YES NO 2. Does anyone in your family other than your parents have a drinking problem?(Required) YES NO Part III1. What alcoholic beverage did you have in your possesion at the time of your citation?(Required)2. What is your favorite type of alcoholic beverage?(Required)3. At what age did you begin drinking (other than a sip of parents drink)(Required)Email(Required) CAPTCHA
