Do you loose time from work because of drinking?
Is drinking making your home life unhappy?
Do you drink because you are shy with other people?
Is drinking affecting your reputation?
Have you ever felt remorse after drinking?
Have you ever gotten into financial difficulties as a result of your drinkng?
Do you turn to lower companions and an inferior environment when drinking?
Does your drinking make you careless of your family's welfare?
Has your ambition decreased because of your drinking?
Do you crave a drink at a definate time daily?
Do you want a drink the next morning?
Does your drinking cause you to have difficulty sleeping?
Has your efficiency decreased because of drinking?
Is drinking jeopardizing your job or business?
Do you drink to escape from worries or troubles?
Do you drink alone?
Have you ever had a complete loss of memory because of drinking?
Do you drink to build up your self-confidence?
Has your physician ever treated you for alcoholism?
Have you ever been treated for alcoholism in a hospital or institution?