Alcohol screening questionnaire (usaudit) 2026

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  1. Click ‘Get Form’ to open the alcohol screening questionnaire (usaudit) in the editor.
  2. Begin by reviewing the introductory section, which explains the importance of your responses for optimal medical care.
  3. In the first question, indicate how often you consume alcohol by selecting one of the provided options: Never, Less than monthly, Monthly, etc.
  4. For the second question, specify how many drinks you typically have on a day when you drink. Use the scale provided to select your answer.
  5. Continue through each question, ensuring to answer honestly. Each question is designed to assess your drinking patterns and their impact on your health.
  6. Once completed, review your answers for accuracy before submitting. You can easily edit any field if needed using our platform's editing tools.

Start filling out your alcohol screening questionnaire today for free and take a proactive step towards better health!

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2022 4.8 Satisfied (138 Votes)
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The 5As are: Asking. Assessing. Advising/ Agreeing. Assisting and. Arranging care/follow up referral for patients.
A score of 1 to 7 suggests low-risk consumption according to World Health Organization (WHO) guidelines. Scores from 8 to 14 suggest hazardous or harmful alcohol consumption and a score of 15 or more indicates the likelihood of alcohol dependence (moderate-severe alcohol use disorder).
What is the MAST Assessment? The MAST screening tool is a 25-question test that is used to help identify an alcohol dependency. MAST stands for The Michigan Alcohol Screening Test. There are also shortened, and modified versions published over time including the Brief MAST, SMAST, and Mm-MAST.
Have you ever felt that you ought to C ut down on your drinking? Do you get A nnoyed by criticism of your drinking? Do you ever feel G uilty about your drinking? Do you ever take an E arly-morning drink (eye-opener) to get the day started or to get rid of a hangover (a little hair of the dog that bit you)?
CAGE Alcohol questionnaire Have you felt the need to Cut down on your drinking? Do you feel Annoyed by people complaining about your drinking? Do you ever feel Guilty about your drinking? Do you ever drink an Eye-opener in the morning to relive the shakes?

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Scoring the audit Scores for each question range from 0 to 4, with the first response for each question (eg never) scoring 0, the second (eg less than monthly) scoring 1, the third (eg monthly) scoring 2, the fourth (eg weekly) scoring 3, and the last response (eg. daily or almost daily) scoring 4.
The score of an audit is calculated by adding up the weighted scores of the audit procedures. The weighted score of an audit procedure is calculated by multiplying the score and the weight of the audit procedure.
Others may pdocHub the 1-2-3 Rule, which means limiting alcohol consumption to one drink an hour, no more than two at once, and no more than three times per week.
Alcohol Assessment How often do you have a drink containing alcohol? How many standard drinks containing alcohol do you have on a typical day when drinking? How often do you have six or more drinks on one occasion?
An alcohol abuse evaluation or any substance abuse assessment will ask you questions such as: How much alcohol do you drink? How often do you drink? What kind of alcohol do you drink? When was your last drink? What were the circumstances surrounding your last drink? Do you ever feel guilty or ashamed after drinking?

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