1. How often does your wife drink?
A. Once a week
B. Twice a week
C. More than three times a week/ almost every day!
2. Does your wife drink during the day?
A. Yes, always
B. Yes, sometimes
C. No, never
3. Does your wife drink alone?
A. Yes, most of the time
B. Yes, sometimes
C. No, never
4. How many glasses of wine does she usually drink in one evening?
A. One or two glasses
B. Three to four glasses
C. The whole bottle
5. Does she get defensive when you talk to her about her drinking habits?
A. Yes, most of the time
B. Yes, sometimes
C. No, never / I haven’t opposed it yet
6. Does she get annoyed often?
A. Very often
B. Sometimes
C. Almost never / Not actually
7. Does she avoid responsibility?
A. Yes
B. Not sure
C. No
8. Does she blame you when things go wrong in your relationship?
A. Yes
B. Sometimes
C. No
9. Does she ever miss out on work or other commitments because she’s too drunk?
A. Yes
B. Not Sure
C. No
10. Have you tried to talk to your wife about rehab before?
A. Yes, many times
B. No, but I want to
C. No, I don’t think I should
