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Hi there, Welcome to The Sober Experiment. Please fill out and submit this form.
12
Questions
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
How many days would you like to commit to sobriety?
30 Days
60 Days
100 Days
1 year or more
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4
How often do you have a drink containing alcohol ?
Never
Monthly or less
2-4 times per month
2-3 times per week
4+ times per week
Other
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5
How often have you had 6 or more units on a single occasion in the last year?
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
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6
How often in the last year have you failed to do what was normally expected of you because of your drinking?
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
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7
What is your usual drink of choice?
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8
What are your reasons for joining the Bee Sober?
Please give as much detail as possible.
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9
Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested you cut down?
YES
NO
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10
In the last 4 weeks have you found that you have needed a drink in the morning in order to cope with the day ahead
YES
NO
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11
Is there anything else that you would like us to know
We want to help you the very best we can, so please list anything you might think we need to know here.
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12
Where did you hear about The Sober Experiment®/Bee Sober?
Facebook, Instagram, Work, Friend etc
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