Survey on impact of Corona-virus on alcohol usage
This survey is for people aged over 18 years of age who have been drinking alcohol over the last 12 months.  It is for the purpose of research on.   Please DO NOT CONTINUE TO ANSWER THE QUESTIONS IF YOU HAVE NOT DRANK ALCOHOL OVER THE LAST 12 MONTHS.
Sign in to Google to save your progress. Learn more
Which country are you from?
Are you male or female?
Clear selection
What age range are you?
Clear selection
BEFORE the year 2020 have you ever sought help for alcohol related problems?  
Clear selection
How would you rate your over-all mood for the last 12 months ?  
Distressed / Depressed
Happy / Content
Clear selection
BEFORE the year 2020 what was your alcohol consumption like?
Clear selection
BEFORE the year 2020 how many units of alcohol  do you consume on a day when you are drinking?
Clear selection
These next questions are about how you have been drinking in the year 2020
SINCE the year 2020 what is your alcohol consumption like?
Clear selection
SINCE the year 2020 how many units of alcohol  do you consume on a day when you are drinking?
Clear selection
How often during 2020 have you found that you were not able to stop drinking once you had started?
Clear selection
How often during 2020 have you failed to do what was normally expected from you because of your drinking?
Clear selection
How often during 2020 have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session?
Clear selection
How often during 2020 have you had a feeling of guilt or remorse after drinking?
Clear selection
How often during  2020 have you been unable to remember what happened the night before because you had been drinking?
Clear selection
Have you or somebody else been injured as a result of your drinking?
Clear selection
Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?
Clear selection
Thank you for taking part in this survey.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms