.
Alcohol Experience Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
Start
Secured
Survio
1
At what age did you first taste alcohol?
Please provide the age at which you first tried alcohol.
2
Who offered you alcohol for the first time?
Select the person who first offered you alcohol.
Family member
Friend
Took it myself
Other: __________
3
What type of alcohol did you first taste?
Choose the type of alcohol you first tried.
Beer
Wine
Hard alcohol
Other: __________
4
How did you feel after your first experience with alcohol?
Indicate your emotional response after trying alcohol for the first time.
Positively
Negatively
Neutral
5
Did you consume alcohol responsibly during this experience?
Please reflect on your responsible drinking behavior during this experience.
Yes
No
6
Did anyone discuss the potential risks of alcohol consumption with you before this experience?
Consider if you were informed about the risks of alcohol consumption prior to this experience.
Yes
No
7
Do you believe your first experience with alcohol influenced your future drinking habits?
Reflect on whether this initial experience impacted your drinking behavior in the long term.
Yes
No
I'm not sure
8
Have you ever experienced negative consequences due to alcohol consumption?
Consider any negative outcomes that may have resulted from drinking alcohol.
Yes
No
9
How often do you consume alcohol now?
Indicate the frequency of your current alcohol consumption.
Daily
Weekly
Occasionally
Rarely
Never
10
Have you sought help or support for alcohol-related issues in the past?
Consider if you have ever looked for assistance regarding alcohol-related concerns.
Yes
No
Submit