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Michigan Alcohol Screen Test (MAST)

Community & Family Resources
Phone 515-576-7261
Fax 515-955-7628
 Client Information
  First Name:  * Last Name:  *  
           
  Date of Birth:  * Birth Sex: 
* 
         
  Address: City:  
  State: Zip Code :  
  Phone No:  
* Date
* 0. Do you enjoy drinking now and then?
YES   NO  
* 1. Do you feel you are a normal drinker?    ("normal" - drink as much or less than most other people)
YES   NO  
* 2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before?
YES   NO  
* 3. Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking?
YES   NO  
* 4. Can you stop drinking without a struggle after one or two drinks?
YES   NO  
* 5. Do you ever feel guilty about your drinking?
YES   NO  
* 6. Do friends or relatives think you are a normal drinker?
YES   NO  
* 7. Are you able to stop drinking when you want to?
YES   NO  
* 8. Have you ever attended a meeting of Alcoholics Anonymous (AA)?
YES   NO  
* 9. Have you ever gotten into physical fights when drinking?
YES   NO  
* 10. Has drinking use ever created problems between you and your wife, husband, a parent, or other relative?
YES   NO  
* 11. Has your wife, husband, or other family member ever gone to anyone for help about your drinking?
YES   NO  
* 12. Have you ever lost friends or girlfriends/boyfriends because of your drinking?
YES   NO  
* 13. Have you ever gotten into trouble at work because of your drinking?
YES   NO  
* 14. Have you ever lost a job because of drinking?
YES   NO  
* 15. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?
YES   NO  
* 16. Do you ever drink before noon?
YES   NO  
* 17. Have you ever been told you have liver trouble? Cirrhosis?
YES   NO  
* 18. After heavy drinking have you ever had delirium tremens (DTs) or severe shaking, or heard voices, or seen things that weren't really there after heavy drinking?
YES   NO  
18a. Did the above include delirium tremens (DTs)?
YES   NO  
* 19. Have you ever gone to anyone for help about your drinking?
YES   NO  
* 20. Have you ever been in a hospital because of drinking?
YES   NO  
* 21. Have you ever been a patient in a psychiatric hospital or on a psychiatric ward of a general hospital where drinking was part of the problem that resulted in hospitalization?
YES   NO  
* 22. Have you ever been seen at a psychiatric or mental health clinic, or gone to a doctor, social worker, or clergyman for help with any emotional problem where drinking was part of the problem?
YES   NO  
* 23. Have you ever been arrested for drunken driving or driving after drinking?
YES   NO  
If YES, How many times?
* 24. Have you ever been arrested, even for a few hours, because of drunken behavior?
YES   NO  
If YES, How many times?
End of MAST
MAST Score:
0-3: Normal
4: Borderline
5+: Alcohol Dependent
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