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H10. ...fighting? <br /> a. No <br /> b. Yes <br /> H11. ... been intoxicated in public? <br /> a. No <br /> b. Yes <br /> H12. Do you ever drink on the job in violation of employer rules? <br /> a. No <br /> b. Yes <br /> H13. How often do you drive after having 4 or more drinks? <br /> a. Never <br /> b. About once a year, or less <br /> c. A few times a year <br /> d. About every other month <br /> e. About once a month <br /> f. A few times a month <br /> g. About once a week or more <br /> H14. How often do you drive while drinking(with an open container in the car)? <br /> a. Never <br /> b. About once a year, or less <br /> • c. A few times a year <br /> d. About every other month <br /> e. About once a month <br /> f. A few times a month <br /> g. About once a week or more <br /> H15. Have you ever been warned by an employer regarding your drinking habits? <br /> a. No <br /> b. Yes <br /> H16. Have you ever been in any kind of trouble after consuming any quantity of alcohol? <br /> a. No <br /> b. Yes <br /> H17. Do you smoke cigarettes? <br /> a. No, never have <br /> b. No, I quit smoking 3 or more years ago <br /> c. No, I quit smoking less than 3 years ago <br /> d. Yes, about one-half pack a day or less <br /> e. Yes, about a pack a day <br /> f. Yes, about 2 packs a day <br /> g. Yes, about 3 packs a day, or more <br /> PSS/LEPS PLLC 78 <br />