The Michigan Alcoholism Screening Test (MAST)
Please circle either Yes or No for each item as it applies to you.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you feel you are a normal drinker? (By normal we mean you drink lessthan or as much as most other people.)
Yes
No
Have you ever awakened the morning after some drinking the night beforeand found that you could not remember a part of the evening?
Yes
No
Does your wife, husband, a parent , or other near relative ever worry orcomplain about your drinking?
Yes
No
Can you stop drinking without a struggle after one or two drinks?
Yes
No
Do you ever feel guilty about your drinking?
Yes
No
Do friends or relatives think you are a normal drinker?
Yes
No
Are you able to stop drinking when you want to?
Yes
No
Have you ever attended a meeting of Alcoholics Anonymous (AA)?
Yes
No
Have you gotten into physical fights when drinking?
Yes
No
Has your drinking ever created problems between you and your wife,husband, a parent, or other relative?
Yes
No
Has your wife, husband (or other family members) ever gone to anyone forhelp about your drinking?
Yes
No
Have you ever lost friends because of drinking?
Yes
No
Have you ever gotten into trouble at work or school because of drinking?
Yes
No
Have you ever lost a job because of drinking?
Yes
No
Have you ever neglected your obligations, your family or your work for twoor more days in a row because you were drinking?
Yes
No
Do you drink before noon fairly often?
Yes
No
Have you ever been told you have liver trouble? Cirrhosis?
Yes
No
After heavy drinking have you ever had Delirium Tremens (D.T.s) orsevere shaking, or heard voices or seen things that really were not there?
Yes
No
Have you ever gone to anyone for help about your drinking?
Yes
No
Have you ever been in a hospital because of drinking?
Yes
No
Have you ever been a patient in a psychiatric hospital or on a psychiatricward of a general hospital where drinking was part of the problem thatresulted in hospitalization?
Yes
No
Have you ever been seen at a psychiatric or mental health clinic, or goneto any doctor, social worker, or clergyman for help with an emotionalproblem, where drinking was part of the problem?
Yes
No
Have you ever been arrested for drunk driving, driving while intoxicated, ordriving under the influence of alcoholic beverages?
Yes
No
If YES, how many times?
Have you ever been arrested, or taken into custody even for a few hours,because of other drunk behavior?
Yes
No
If YES, how many times?
Submit
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