SELF ASSESSMENT - ALCOHOL
This self assessment form is designed to help you measure
your alcohol intake and decide whether or not you should
cut down on your drinking.
HOW MUCH ALCOHOL DID YOU DRINK LAST WEEK?
Count your score in units: 1 unit = one glass of wine
2 units = one pint of beer or one Irish measure of spirits
|
DAY |
AMOUNT |
UNITS |
|
Monday |
|
|
|
Tuesday |
|
|
|
Wednesday |
|
|
|
Thursday |
|
|
|
Friday |
|
|
|
Saturday |
|
|
|
Sunday |
|
|
WHAT WAS YOUR TOTAL IN UNITS?
|
MEN |
RISK |
WOMEN |
|
Up to 21 units |
No long term risk |
Up to 14 units |
|
22 - 35 units |
Be careful - continued drinking at this level may cause harm |
15 - 21 units |
|
36 - 39 units |
Drinking at this level likely to harm your health - ** CUT DOWN NOW ** |
22 - 35 units |
|
50 + units
|
You may be dependent on alcohol. You may develop problems with your liver, stomach or memory |
36 + units |
Courtesy of : Dr. Paul Guéret, Dr. Patricia Holland and Dr. Robert Ryan
By appointment: 7.15am - 5.45pm
Telephone: 6761493 / 6613088 Fax: 6614787