CAGE QUESTIONNAIRE

Alcohol Use Screening Tool

Patient First name*

Patient Last name*

Instructions: Please answer each question by checking Yes or No.

Have you ever felt that you should cut down on your drinking?*

Yes

Have people annoyed you by criticizing your drinking?*

Yes

Have you ever felt bad or guilty about your drinking?*

Yes

Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (an “eye-opener”)?*

Yes

CAGE-AID (Alcohol and Drug Use Screening Tool)

Have you ever felt that you should cut down on your drinking or drug use?*

Yes

Have people annoyed you by criticizing your drinking or drug use?*

Yes

Have you ever felt bad or guilty about your drinking or drug use?*

Yes

Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (an “eye-opener”)?*

Yes

Scoring and Interpretation

Each Yes response = 1 point

Each No response = 0 points

Total Score Range: 0–4

A total score of 2 or more is considered clinically significant and may indicate a potential alcohol- or substance-use disorder. Further assessment is recommended.

Note: The CAGE and CAGE-AID are screening tools, not diagnostic instruments. Clinical judgment and additional evaluation should be used when interpreting results.

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FAX : 507-738-1963

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