Full Audit C

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Thank you for informing us of your alcohol intake on your registration form. The Dept of Health recommends that patients with a score of 5 or more should complete the full questionnaire, which is located below.

 

Depending on the result, your Doctor may wish to see or speak to you, if you have a preferred contact method or number would you please provide this.

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For advice on alcohol support click here 

Full Audit C Questionnaire
1. How often during the last year have you found that you were not able to stop drinking once you had started?
2. How often during the last year have you failed to do what was normally expected from you because of your drinking?
3. How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session?
4. How often during the last year have you had a feeling of guilt or remorse after drinking?
5. How often during the last year have you been unable to remember what happened the night before because you had been drinking?
6. Have you or somebody else been injured as a result of your drinking?
7. Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

If you are not happy to tick the boxes above please write down your details as requested above and return it to the surgery.

Thank you for submitting, we will update your records

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