'Kick Off'
 'Tackling Mental Health for Rugby League'
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'Sports do not build character, they reveal it.'

 

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 Kick Off...Mental Health for Rugby League

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Kick Off Alcohol Assessment

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Alcohol Self Assessment


In completing this assessment, please be aware that any information or personal details will be kept private and confidential, according to our Privacy Policy. 

These questions are designed to ascertain whether there may be a problem with alcohol, though do not confirm or refute. The questionnaire is not a replacement for medical or psychological advice and is for informational & educational purposes only. 

Should you have concerns regarding your health & well being in relation to alcohol consumption please contact your GP or other health professional. You may also make contact with the ‘Kick Off’ team.   

 


 

 

          Do you sometimes wake in the morning after a big night out & can’t 

             remember periods of the night before?            Yes  No  

                                                                

          Do you have a habit of arguing or getting into fights when you are out 

          drinking?              Yes  No 

 

            Does your spouse or partner complain about your drinking?        Yes  No 

 

          Do your family or team mates express concern  

           about your drinking?        Yes  No 

 

             Are you often the first person to arrive for a night out drinking, and  

           generally the last one to go home?           Yes  No 

 

              After a few drinks, do you find it difficult to stop or slow down,  

           tending to keep going?             Yes  No 

 

              Do you find yourself apologizing for behaviour during those periods 

           when you have been drinking?               Yes  No 

 

            Do you ever drink before noon?            Yes  No 

      

           Has your job or career been affected by your drinking? Have you ever  

            been sacked, fined or reprimanded as a result?         Yes  No 

 

             Have you ever been late for training due to drinking the night before? 

            Or, have you ever arrived at training intoxicated?        Yes  No 

  

            Has your name performance ‘on field’ ever been affected as a result of 

            your drinking?        Yes  No    

                        

             Have you ever been in trouble with the law (eg. Drink driving)?   Yes  No    

                        

             Have you lost wives, partners, girlfriends etc. as a result of your  

             drinking?            Yes  No 

                             

             Do you drink every day?             Yes  No 

                             

             Have you ever had any side effects from drinking such as: tremor, 

             ‘burning’ stomach pain, blurred vision, headache, unsteady gait (when

             walking) – the day after you have been drinking?             Yes  No 

If you answered yes to 4 or more of the questions, further assessment by the appropriate skilled clinician should be sought. Please contact your GP or other related medical professional. Alternatively, you may contact the ‘Kick Off’ team if you wish.


                                                                                       

                                                                                                

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