.

Alcohol

Dobrý den, věnujte prosím několik minut svého času vyplnění následujícího dotazníku.

Zabezpečeno
1

Gender

2

Age

3

Which diagnosis best describes your distress?

Is not necessary to have a diagnosis made by a doctor, just where you would be classified
4

Are you treating your affliction?

5

How often do you consume alcohol?

6

For what purpose do you consume alcohol?

7

Where and with whom do you consume alcohol most often?

8

Are you aware that you are using alcohol to self-medicate your pain?

9

Do you feel at risk of alcohol addiction?

Thank you very much for filling it out!