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Alcohol Free Personal Coaching Assessment

After completion of this assessment, you'll get an email to schedule the "Alcohol Free Personal Coaching" session.

Click the button below to start.

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Question 1 of 7

How many alcoholic drinks do you consume each week?

A

1 to 5

B

6 to 10

C

11 to 15

D

16 to 20

E

Over 20

Question 2 of 7

When was the last time you were sober for 30 days (or longer)?

A

Over the last 60 days

B

Over the last 90 days

C

Over the last 120 days

D

Over the last 180 days

E

I can't remember.... it's been that long

Question 3 of 7

How much money do you spend on alcohol on a monthly basis?

A

$80 - $100 USD

B

$100 - $150 USD

C

$150 - $200 USD

D

$200 - $250 USD

E

Over $300 USD

Question 4 of 7

On a scale 1 (low commitment) to 10 (high commitment), subjectively score your commitment to being Alcohol Free for 30 days?

Question 5 of 7

What type of drinker are you?

A

Social Drinker (Drink a couple time per month, don't drink to get drunk, but it happens occasionally)

B

Alcohol Abuser (Takes drinking to far, typically take social drinking to extreme drinking, you may drive under the influence, you're able to not drinking, however you plan when you will.)

C

Alcoholic (Addiction to alcohol, unable to control or set limits on your drinking)

Question 6 of 7

What have you done to try to either stop drinking or at least get it under control?

(Select all that apply)
A

Alcoholics Anonymous (AA)

B

Therapy

C

Meditation

D

Book(s)

E

Medical doctor

F

Some other group program

G

Online digital courses

Question 7 of 7

Explain why you want a "Alcoholic Free Personal Coaching session? What will this mean to you? What change are you seeking?

Confirm and Submit