AUDIT-C Alcohol Use Screening — FHIR Questionnaire Template

Three-question alcohol consumption screen with an automatic total score (0–12) and the usual positive-screen thresholds.

Scoring

Each answer scores 0–4. The total (0–12) is a positive screen at 4 or more for men and 3 or more for women.

Questions

1. How often do you have a drink containing alcohol?
   • Never
   • Monthly or less
   • 2-4 times a month
   • 2-3 times a week
   • 4 or more times a week
2. How many standard drinks containing alcohol do you have on a typical day?
   • 1 or 2
   • 3 or 4
   • 5 or 6
   • 7 to 9
   • 10 or more
3. How often do you have 6 or more drinks on 1 occasion?
   • Never
   • Less than monthly
   • Monthly
   • Weekly
   • Daily or almost daily

Calculated results

• AUDIT-C total score (0–12)

Source and license

Source: Bush et al. 1998, Arch Intern Med 158:1789 (AUDIT-C, from the WHO AUDIT). Codes and answer lists: LOINC, as in the HL7 US Core AUDIT-C questionnaire. (link)

License: No restrictions on use (per the ONC USCDI/ISP listing; submitted by NIAAA). (link)

Provided to save authoring effort, not as medical advice — confirm the scale and its cut-offs for your use case.

Use it

1. Download the FHIR Questionnaire JSON, or
2. open the Builder, choose + Add → From template…, search for “AUDIT-C Alcohol Use Screening” and insert it. It arrives as one titled group with its calculations wired, and you can keep editing it.

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This material contains content from LOINC (loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the LOINC license.