Alcohol Consumption Review

If you have been invited to submit an alcohol consumption review, please complete this form.


Alcohol Questionnaire

Your Details

Full Name
Date of Birth

Alcoholic Units

2 units = 1 pint beer or 1 glass of wine (175mls),

1 unit = single measure of spirits,

1.5 units = alcopop or a can of Lager,

9 units = 1 bottle of wine.

If your score is above 8, please make an appointment to discuss your alcohol use or visit www.nhs.uk/live-well/alcohol-advice/alcohol-support/.