Alcohol Questionnaire
Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.
The NHS recommends limiting the amount of alcohol consumed to within healthy limits. For men this is not more than 21 units per week, including no more than 3-4 units per day. For women this is 14 units per week, including no more than 2 to 3 units per day.
If you are concerned about your level of drinking or need help cutting down, please book an appointment with a doctor.
Privacy Protection
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key and is accessed over a secure
connection by nominated staff. We have a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
Learn more about our Privacy Policy and
Terms of Use.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.