Alcohol Recovery Self-Assessment Form
Reflect on your journey and current progress in alcohol recovery. Your answers are for your own self-awareness and growth.
How often do you currently experience cravings for alcohol?
*
Never
Rarely
Sometimes
Often
Very Often
In the past month, how many days have you consumed alcohol?
*
0 days
1-2 days
3-5 days
6-10 days
More than 10 days
How confident do you feel in your ability to stay sober in challenging situations?
*
1
2
3
4
5
How often do you use healthy coping strategies (such as exercise, mindfulness, or reaching out for support) instead of drinking?
*
Never
Rarely
Sometimes
Often
Always
How supported do you feel by friends, family, or support groups in your recovery?
*
1
2
3
4
5
Please rate your agreement with the following statements.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am aware of my triggers for drinking.
1
2
3
4
5
I have a plan for managing urges to drink.
6
7
8
9
10
I believe in my ability to recover.
11
12
13
14
15
I am committed to my recovery goals.
16
17
18
19
20
What motivates you the most to continue your recovery?
How would you describe your overall progress in recovery so far?
*
Excellent
Good
Fair
Needs Improvement
How frequently do you attend recovery meetings or support sessions?
*
Never
Rarely
Sometimes
Often
Always
What is one area you would like to focus on improving in your recovery?
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