New Patient Registration Form Page 3

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This is one unit of alcohol…
…and each of these is more than one unit
AUDIT – C
Scoring system
Your
Questions
score
0
1
2
3
4
2 - 4
2 - 3
4+
How often do you have a drink
Monthly
times
times
times
Never
containing alcohol?
or less
per
per
per
month
week
week
How many units of alcohol do you drink
1 -2
3 - 4
5 - 6
7 - 9
10+
on a typical day when you are drinking?
Daily
How often have you had 6 or more units
Less
or
if female, or 8 or more if male, on a
Never
than
Monthly
Weekly
almost
monthly
single occasion in the last year?
daily
Scoring:
A total of 5+ indicates increasing or higher risk drinking.
An overall total score of 5 or above is AUDIT-C positive.
SCORE
3
Doc. Ref –
Version –
Filename: Identify Patient Needs Protocol + New Patient Registration Policy & Form Page of 3

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00 votes

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