Drinks Diary

Your Drinks Diary

A way to keep a record of your day for you and your clinician.

There is evidence that self-monitoring your drinking to spot patterns is an important part of preparing for the changes you want to make.

Please confirm your email address:

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What date is this entry for?

(Remember you can complete this diary more than once per day if needed)

Date entry relates to

Please select a date.

Did you drink alcohol on this day?

(Remember not to make any sudden changes to your alcohol consumption without discussing with your clinician)

Did you drink on this day?

Yes

How do you feel about not drinking during this period?

List out any feelings you felt at the time, or are still feeling now.

I felt:

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During what time period did you drink?

Don't worry if you're not sure - this can be approximate.

I drank from

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I drank until

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Where were these drinks consumed?

Select all that apply

I consumed drinks in these locations:

Who did you drink with?

Select all that apply

I consumed alcohol with these people:

What did you drink?

Select all that apply

I drank these drinks:

How much did you drink?

Provide an estimate of how many units of alcohol you consumed. (One unit is approximately half a pint of regular beer, half a medium wine or a single measure of spirits)

Total Units Consumed

Please specify an answer

How much did it cost?

Provide an estimate of how much it cost (include the cost of any drinks purchased by others)

Total Cost Estimate

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What were you doing immediately before your first drink?

Immediately before drinking I was:

Please specify an answer

How were you feeling at that time?

At the time I was feeling:

Please specify an answer

How did you feel whilst drinking?

List out any feelings you remember during that time.

During drinking I felt:

Please specify an answer

How did you feel after drinking?

List out any feelings after drinking, including any you may still be feeling now.

After drinking I felt:

Please specify an answer

Looking back at that time, is there anything else you want to add?

Include any other thoughts, reflections, learning or questions this has raised for you.

Final Reflections

Please specify an answer

Your Drinks Diary

A way to keep a record of your day for you and your clinician.

There is evidence that self-monitoring your drinking to spot patterns is an important part of preparing for the changes you want to make.

What date is this entry for?

(Remember you can complete this diary more than once per day if needed)

Did you drink alcohol on this day?

(Remember not to make any sudden changes to your alcohol consumption without discussing with your clinician)

How do you feel about not drinking during this period?

List out any feelings you felt at the time, or are still feeling now.

During what time period did you drink?

Don't worry if you're not sure - this can be approximate.

Where were these drinks consumed?

Select all that apply

Who did you drink with?

Select all that apply

What did you drink?

Select all that apply

How much did you drink?

Provide an estimate of how many units of alcohol you consumed. (One unit is approximately half a pint of regular beer, half a medium wine or a single measure of spirits)

How much did it cost?

Provide an estimate of how much it cost (include the cost of any drinks purchased by others)

What were you doing immediately before your first drink?

How were you feeling at that time?

How did you feel whilst drinking?

List out any feelings you remember during that time.

How did you feel after drinking?

List out any feelings after drinking, including any you may still be feeling now.

Looking back at that time, is there anything else you want to add?

Include any other thoughts, reflections, learning or questions this has raised for you.

All Set! (Just Hit Submit)

Thank-you for completing today's drinks diary.

A copy will be sent to you, so that you have a record of your responses over this period.

You can discuss any patterns you observe at your next clinical appointment.

Your diary has been received and you can close this window.

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