SURVEY

DRY SEASON CHALLENGE

This is the first part of your week 1 kickoff.  Please complete the below survey. 

 

Yes No

  1.  Have you ever decided to stop drinking for a week or so but only lasted for a couple of days?

  2. Do you wish people would mind their own business about your drinking?

  3. Have you ever switched from one kind of drink to another with hopes that this would keep you from getting drunk?

  4. Have you had to have an eye-opener upon awakening during the past year?  (drink to get started stop shaking)

  5. Do you envy people who can drink without getting into trouble

  6. Have you had problems connected with drinking during the past year?

  7. Has your drinking caused you trouble at home?

  8. Do you ever try to get “extra” drinks at a party because you do not get enough?

  9. Do you tell yourself you can stop drinking any time you want to, even though you keep getting drunk when you don’t mean to?

  10. Have you missed days of work or school because of drinking?

  11. Do you have blackouts?

  12.  Have you ever felt that your life would be better if you did not drink?

 

Other

  1. Would you rate yourself as a social drinker or more of a dependent drinker?

  2. How many times a week do you drink?

  3. What do you want to achieve in your dry season?

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