General Health and Lifestyle Questionnaire

If you have been requested by the practice to do so, please fill out this form.

General Health Questionnaire

General Health Questionnaire

Section

Smoking status: *
Are you interested in advice on how to quit?

Please visit our Wellbeing Centre for more information about quitting smoking.

This is one unit of alcohol:

Amount of different types of drink representing one unit of alcohol

And each one of these, is more than one unit:

Amount of different types of drink representing more than one unit of alcoholAmount of different types of drink representing more than one unit of alcohol
How often do you have a drink containing alcohol? *
How many units of alcohol do you drink on a typical day when you are drinking? *
How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? *
*