Alcohol Abuse
  • 3rd Leading Cause of Death
  • 50% More Hospitalizations
Assessment Questions
Complete Answers Help Us Cure Your Faster!  Expand Your
Answers With What And Why.  Fill every blank, NA if No Answer.
*Required
*
Your name:
*
Home Phone Number
*
Cell or Other Phone
Primary Email:
*
*
Repeat Email:
Age?
*
Sex?
*If Female-take contraceptives?
Diabetic?
Hypoglycemic?
*
Prescription Drugs, Alcohol Related:
Anti Anxiety?
Attention Deficit?
Antidepressants?
Sleep Disorders?
Blood Pressure?
Triglycerides?
Cholesterol?
OTHER DRUGS: Prescription or other and reason for each:
*
What alcohol abuse treatments have been tried and failed and Why?
What was your "Alcohol Scare" that has you looking to be cured today?
What would be a reasonable goal for you?
COUNT CAREFULLY, most of us drink twice what we think and spend even more.
1 ounce or 30 ml hard liquor = 1 glass of wine = 1/5 standard wine bottle = 12 ounces.
How many ounces per day of alcohol in:
Hard liquor?
Wine?
*
Beer?  
Estimated Cost/day of all drinking (including bars, restaurant, tips)?
*
Number of days/month you binge (double that or more?)
*
How many years or more than 2 ounces per day?
Height?
Weight?
Total Cholesterol?
If you know them:
Blood Pressure?
If you are joining us partly to lose weight, what is your weight loss goal?
What Street Drugs if any?  (Held in confidence, see Privacy Policy.)
Three Most Favorite Foods Craved in the last three months?
Usual Diet?  Fast foods and canned foods do not count.
Red Meat:  How many times/week?
Meat of all kinds:  How many times/week?
Fruits:  How many times/week?
Vegtables: How many times/week?
Do you take a multivitamin pill?  
What other vitamins do you take?  
What other nutraceuticals do you take?  
Most Strenuous thing you do more than twice a week?
How many times per week.
Any job related pressures to drink?
Job Description?
Other Sources of Stress?
Diseases or Symptoms not mentioned above?
Brain Damage or Liver Damage Symptoms you have noticed?
These "Marketing Questions" also help us know what your brain needs.
About how many pages of our site have you read already?
How did you hear about us?  Google, Links
from related Websites, or Friend ?
What key word or phrase was used for your search?
Name and email of your "Help a Friend"?
Anything else we should know?
Better Answers Help Us Cure Your Faster!
Expand Your Answers With What And Why.  
After pressing here, BE PATIENT.  You may have a 20 second wait while your Assessment
answers are confidentially transmitted.  If longer, call
904-234-0103
By submitting your Free Assessment you agree to terms and conditions.  
Fees are partially refundable except low cost New
Cure Yourself Program.  
Do Your Assessment - Then Sign Up
Your Big Decision -
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or Create A
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Haven't we made
sense to you?  Many
health professionals
think so too
(including
MD and other doctors)
.  
They are now
Social
Drinking
members.
To protect your
privacy
do not
use employers
email address.  
Also,
many
employers
routinely block

your First
Recommendations
because of its
large size, or the
two attachments.

EMails often are
undeliverable

now or later.
Phone numbers
are often the only
way we can
contact you.  
We
will not use your
number for any
other reason.
Confidentiality: All your personal information is protected by doctor patient privilege and
high level unencrypted computer security measures that have never been breached.
Any Other
Problems?
Please
send email to
Alcoholism Cure  
You agree?
  • You would really like a solution to your heavy drinking?
  • That's why you clicked on our link.
  • Are we more science based than anything you have every experienced?
  • That's why you are still reading.  And look left at that list of topics.  
  • Are you beyond "No problem, I only drink a six-pack or bottle a day?"
  • Yet doctors say 2+ ounces/day will eventually kill you!
  • You know it's hard to control cravings with bad brain chemistry.  
  • Your last excuse is you enjoy alcohol.  
  • That's fine, we have the only treatment that does both.

You already know our typical Very Heavy Drinker is cured in 1-10 weeks before spending
$350 in fees and ingredients.  Then $12/day average
Cure Dividend Savings typically exceed
fees.  Difficult cases spend a few hundred more, and everyone is at least
Drinking Down Half before five
months.  Almost no risk, virtually free, replace alcohols ups and down with a stable good mood -- this
is the best opportunity to which you will ever say "Yes!".  


Didn't join us yet?  For some, it also takes a swift kick in the pants, or emotional reasons
for joining.  Job loss, divorce, DWI, bad news from the doctor, they  seem so far away.

Remember reading the last thoughts of the sober teenage girl struck down by a drunk
driver as she dies?  That can happen to any abuser with as little as two drinks.  Do the
right thing,
Need
Help?
Call
904-234-0103
We ask you to
commit to fees that
step up in the
second and fourth
months based on
our certainty of
your cure or at
least substantial
progress.  If no
progress, you may
cancel at any time
as we describe.  

Step up fees are
not a new expense
for you, they will
be paid by your
Cure Dividend,
the money you
save by purchasing
less alcohol.  Of
course, some
results are slower
than typical.  
We
cheerfully refund
amounts over
your base fee
not
being paid by your
Cure Dividend as
we explain.
    What did You Think About Our
    Unique Permanent Cure Programs?
       $35,000,000 Scientific Validation
      by the American Psychiatric Association      
Is your alcoholic high worth:
  • Long term depression?
  • Aging Faster?
  • Poor health?
  • 50% more hospitalizations?
  • Dying 15 years sooner?
When you can safely have a better mood?
Of course not!
Your Last Chance to Cure Yourself
Still need the traditional comfort of hearing a deep and knowledgeable voice helping you sign up?
Our doctors time is our biggest expense.  We are very busy serving members and have to restrict
their phone time. Have your specific questions written down and
call 904-234-0103.    

FREE Assessment
for next 200 members
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updated daily
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Alcoholism Cure Foundationtm
  • We cheerfully refund step up fees if you are not Drinking Down Half in the typical 1-10 weeks.  This typically
    keeps your cost (including ingredients) less than a single bar drink/day.  
  • You may cancel anytime you are not at least Drinking Down Half after following your program for five months,
    or we can not bring you down to Social Drinking within a reasonable time afterwards.  Then Cure Dividend
    Savings typically exceed all costs, and your program is virtually cost free until you are Permanently Cured.
Patents Pending
Copyright (C) 2003-2008 by Alcoholism Cure Foundation
    No statements on this website have been evaluated
    by the Food & Drug Administration "FDA".  
Help?
Call
904-234-0103
No Alcohol Cravings
Means
No Alcoholism.  

No Alcoholics
Anonymous
meetings either.
Molecule Multiplicity, Permanent Cure, Safety Net, Social Drinking and Sudden Success