Alcohol Screening Questionnaire (AUDIT)

Drinking alcohol can affect your health and some medications you may take. Please help us provide you with the best medical care by answering the questions below.

One Drink equals: 12 oz beer, 5 oz. wine, 1.5 oz liquor (one shot)

 

Fields marked with a * are required

If your score is 16 or higher, an assessment is recommended. Please call 503-535-1151 to schedule an assessment or discuss treatment options. You can also let us contact you.