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How old are you?
 
14
 
15
 
16
 
17
 
 
 
What is your gender?
 
Female
 
Male
 
 
 
Have you ever consumed alcohol?
 
Yes
 
No
 
 
 
At what age did you start drinking alcohol?
 
 
 
 
When was the last time you consumed alcohol?
 
Yesterday
 
On the weekend
 
1 week ago
 
More than a week ago
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
How often do you drink?
 
Everyday
 
3-5 times a week
 
Once a week
 
Only on weekends
 
 
 
Why did you start consuming alcohol?
 
Peer Pressure
 
Curosity
 
"You felt like it"
 
INfluence of an adult, older siblings or older friends
 
 
 
Have you ever passed out or experienced memory loss due to drinking?
 
Yes
 
No