CONFIDENTIAL eCHECKUP ALCOHOL POST SURVEY QUESTIONS*

First Initial:  
 
Last Initial:   
 
Student Id #:      
 
Today's Date:  

1.  How many standard drinks of alcohol do you have in a typical MONTH?

2. How many standard drinks of alcohol do you have in a typical  WEEK?

3.  How important is it to you to make any changes in your personal use of alcohol?

(1=Not at all Important; 10=Very Important)

4.  How confident are you that you could make any change in your personal use of alcohol, if you wanted to? 

(1=Not at all Confident; 10=Very Confident)

* Please note, the eCHECKUP post-survey is confidential and only CAPS staff and admin have access to your responses.