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  1. Surveys
  2. 2013
  3. October
  4. A
  5. Alcoholic Beverages
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Questions marked with an * are required Exit Survey
 
 
* 1. What is your age?
 
21-25
 
26-30
 
31-35
 
36-40
 
41-45
 
46-50
 
51-55
 
56-60
 
61-65
 
65 +
 
 
* 2. Are you..........
 
Male
 
Female
 
Other
 
 
 
* 3. How often, on average, do you consume alcoholic beverages?
 
Daily
 
Weekends
 
Weekly
 
Bi-weekly
 
Monthly
 
Bi-monthly
 
Quarterly
 
Annually
 
Holidays only
 
Holidays & Birthdays only
 
Any Special occasion or event
 
I don't drink
 
Other
 

 
4. What types of Alcoholic Beverages do you drink?
Yes No
* Beer
* Energy Beer
* Wine
* Premixed (from the store)
* Coolers (i.e. Mikes, Bartles & James, etc.)
* Vodka
* Bourbon
* Whiskey
* Scotch
* Brandy
Yes No
* Cognac
* Rum
* Schnapps
* Flavored Liquor
* Mixed Drinks
* Blended Drinks (Margaritas, Daquaries, etc.)
* Shaken Drinks
 
 
* 5. What types of beer do you usually drink? (Select all that apply.)
 
Budweiser
 
Bud Light
 
Bud Light Platinum
 
Bud Light Lim-A-Rita
 
Bud Light Strawber-Rita
 
Budweiser Black Crown
 
Bush
 
Bush Light
 
Bush N/A
 
Miller
 
Miller Light
 
Miller High Life
 
Michelob
 
Michelob Ultra
 
Coors
 
Coors Light
 
Corona
 
Milwakee's Best
 
N/A
 
Other
 

 
 
* 6. Where do you feel most comfortable drinking? (Select all that Apply)
 
Home
 
Local Bar
 
Night Club
 
Friend's House
 
Special Events Location
 
Camping/ Vacationing
 
Other
 

 
 
* 7. Do you ever use a designated driver?
 
Sometimes
 
Always
 
Never
 
 
* 8. When you drink, do you usually drink to.......
 
Be Sociable
 
Get a buzz
 
Get tipsy
 
Get drunk
 
Get wasted
 
Just flat out forget
 
Other
 
 
9. Have you ever had any of the following happen after drinking and driving?
Yes No
* D.W.I
* Accident (no one else involved)
* Accident with another vehicle
* Accident with injuries to you or someone else
* Accident resulting in a fatality
* Woke up in your car somewhere else
* Woke up in your car at home
* Woke up in your yard
* Woke up in someone else's yard
* Other
 
 
* 10. What type of mood do you usually get in when you are drunk? (Select all that apply)?
 
Happy
 
Quiet
 
Angry
 
Sad
 
Flirty
 
Other