Alcohol Effects Questionnaire Form
Please answer the following questions to describe how alcohol typically affects you. Your responses are confidential and help us understand your experiences.
How often do you consume alcoholic beverages?
*
Never
Rarely
Occasionally
Frequently
Very Frequently
Alcohol helps me feel more relaxed in social situations.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
After drinking alcohol, I feel more outgoing or talkative.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Alcohol makes it easier for me to forget my worries or stress.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
How would you rate the intensity of positive feelings you experience after drinking alcohol?
*
1
2
3
4
5
I am more likely to take risks after consuming alcohol.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Alcohol sometimes makes me feel tired or drowsy.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
How often do you experience negative effects (such as headache, nausea, or regret) after drinking?
*
Never
Rarely
Sometimes
Often
Always
Please describe any other effects you notice after drinking alcohol.
Submit
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