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Gender
 
Male
 
Female
 
 
 
How often do you drink alcohol per week?
 
none
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
 
 
Which type of alcohol do you prefer?
 
Dark liquor
 
White liquor
 
Wine
 
Champagne
 
Beer
 
 
 
Do you drink alcohol during speacial occasions? (Example: Graduation, Holidays, Birthdays)
 
Yes
 
No
 
 
 
Do you enjoy having a beverage at home or the nightclub or bar with friends or family?
 
Nightclub/Bar
 
Home
 
 
 
Do you feel 21 is an appropiate age to legally drink alcohol?
 
Yes
 
No
 
 
 
On the days you drink, how many drinks do you intake?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
 
 
Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before?
 
Yes
 
no
 
 
 
Does your spouse or partner drink?
 
Yes
 
No
 
 
 
Do you ever drink before noon at a bar or restaurant?
 
Yes
 
No
 
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