Sample Feedback Sheet

  1. Based on the information I obtained during the assessment, I calculated the number of "standard drinks" you consumed each day and have summarized three important indicators of your drinking:
    Total number of standard drinks per week _____
    Average number of standard drinks per drinking day _____
    Highest consumption in a day _____
  2. When we look at everyone who drinks in the United States, you have been drinking more than approximately _____ percent of the population of women/men in the country.
  3. I also estimated your highest and average blood alcohol level (BAL) in the past month. Your BAL is based on how many standard drinks you consume, the length of time over which you drink that much, whether you are a man or a woman, and how much you weigh. So,
    Your estimated peak BAL in an average week was _____
    Your estimated average BAL in an average week was _____

    This is a measure of how intoxicated you typically become. In the U.S. the legal intoxication limit is .08 or .10 (you may want to confirm the BAL limit for your specific state).
  4. You have experienced negative consequences from drinking. Here are some of the most important:
    ________________________ ________________________
    ________________________ ________________________
    ________________________ ________________________