This Form is Currently Unavailable

There is currently a technical issue with this form.
We are doing all we can to correct this.
Please return at a later date, or, if urgent, contact the Practice.

Home Page

FAST ALCOHOL SCREENING TEST (FAST)

Please complete all questions below.

Personal Details

Full Name: Date of Birth: Postcode:

Fast Alcohol Screening Test (FAST)

Unit definition: 1 Glass of Wine = 1.5 Units, 1 Bottle = 10 Units, 1 Pint of Beer = 3 Units, 1 Spirit Measure = 1 Unit

Enter the number (0 to 4) that corresponds to your answer in the box.

How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year?

0 Never

1 Less than monthly

2 Monthly

3 Weekly

4 Daily or almost daily

How often during the last year have you failed to do what was normally expected from you because of your drinking?

0 Never

1 Less than monthly

2 Monthly

3 Weekly

4 Daily or almost daily

How often during the last year have you been unable to remember what happened the night before because you had been drinking?

0 Never

1 Less than monthly

2 Monthly

3 Weekly

4 Daily or almost daily

Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

0 No

2 Yes, but not in the last year

4 Yes, during the last year

Send Your Request

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form

Menu

This Form is Currently Unavailable

FAST ALCOHOL SCREENING TEST (FAST)

Personal Details

Fast Alcohol Screening Test (FAST)

Send Your Request

Essential pages