Alcohol addiction assessment

If you are in a state of crisis or need immediate help for any reason, please refrain from filling out this assessment and call 911. If you feel that you are a danger to yourself, please refrain from filling out this assessment and contact the National Suicide Prevention Lifeline at 1-800-273-8255.

This online Alcohol Addiction assessment takes approximately five minutes and will provide general feedback when completed. Please note that this assessment is not a formal diagnostic tool and should not be interpreted as such. This assessment is free and can be taken anonymously, if you choose.

If you answer “yes” to any of the questions provided, it is highly recommended that you contact the staff at Harbor Oaks Hospital or another qualified healthcare provider. If you would prefer to be contacted by the staff at Harbor Oaks Hospital, please leave your contact information in the space provided at the end of this assessment. Please note that by leaving your information, you consent to allow Harbor Oaks Hospital to use this information to contact you. Any information provided will remain confidential. If you choose to not leave your information, the staff at Harbor Oaks Hospital will not contact you.

If you answer “no” to the questions provided, you are still encouraged to reach out to the staff at Harbor Oaks Hospital or another qualified healthcare provider for a detailed evaluation of your risk for Alcohol Addiction.

1. Have you ever lied to or otherwise attempted to deceive friends, family members, or colleagues about how often and/or how much you drink?

Yes No

2. Have you ever had problems in school, at work, or in social settings as a result of drinking?

Yes No

3. Have you ever had alcohol-related legal problems, such as being cited for public drunkenness or driving while impaired?

Yes No

4. Have you ever had an alcohol-related blackout, or awakened after a night of drinking with no memory of what you did while you were drunk?

Yes No

5. Do you need a drink to get going in the morning, or to relax at night?

Yes No

6. Do you drink in order to deal with stress, pressure, and other negative experiences?

Yes No

7. Do you feel as though you need to drink in order to enjoy yourself at parties, sporting events, or other social gatherings?

Yes No

8. Do you ever plan to have just a drink and end up consuming much more than you originally intended?

Yes No

9. Have you ever tried and failed to reduce the amount or frequency of your drinking?

Yes No

10. When you’re not able to have a drink when you want one, or when you’re trying to cut down or stop drinking, do you begin to feel anxious, agitated, or otherwise not right?

Yes No

11. Have friends or loved ones ever expressed concern to you about your drinking?

Yes No

12. Are you worried that you might have a problem with alcohol?

Yes No

Thank you for taking Harbor Oaks Hospital's Alcohol Screening.

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Disclaimer: Harbor Oaks Hospital disclaims any liability, loss, or risk sustained as a consequence, directly or indirectly, of the use and application of these assessments.

Free Confidential Alcohol Addiction Assessment

Alcohol addiction assessment

1. Have you ever lied to or otherwise attempted to deceive friends, family members, or colleagues about how often and/or how much you drink?

2. Have you ever had problems in school, at work, or in social settings as a result of drinking?

3. Have you ever had alcohol-related legal problems, such as being cited for public drunkenness or driving while impaired?

4. Have you ever had an alcohol-related blackout, or awakened after a night of drinking with no memory of what you did while you were drunk?

5. Do you need a drink to get going in the morning, or to relax at night?

6. Do you drink in order to deal with stress, pressure, and other negative experiences?

7. Do you feel as though you need to drink in order to enjoy yourself at parties, sporting events, or other social gatherings?

8. Do you ever plan to have just a drink and end up consuming much more than you originally intended?

9. Have you ever tried and failed to reduce the amount or frequency of your drinking?

10. When you’re not able to have a drink when you want one, or when you’re trying to cut down or stop drinking, do you begin to feel anxious, agitated, or otherwise not right?

11. Have friends or loved ones ever expressed concern to you about your drinking?

12. Are you worried that you might have a problem with alcohol?

Thank you for taking Harbor Oaks Hospital's Alcohol Screening.