| {!! $UnTip !!} | What is your height? |
Kilograms
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| {!! $UnTip !!} | What is your weight? |
Meters
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What is your average weekly level of alcohol consumption in units?
* 1 pint of beer/lager = 2 units. 1 125ml glass of wine = 1 unit. 1 25ml measure of spirits - 1 unit |
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| {!! $UnTip !!} | Have you ever been medically advised to reduce your alcohol consumption? This includes being referred for specialist support such as to an alcohol addiction unit or Alcoholics Anonymous |
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* Please confirm which of the following options apply to you in relation to being advised to reduce your alcohol consumption: |
| {!! $UnTip !!} | Are you, or have you ever been an active member of Alcoholics Anonymous or a similar support group? |
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| {!! $UnTip !!} | Have you ever taken drugs that were not prescribed by a doctor? |
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| {!! $UnTip !!} | Do you intend to reside, work or travel outside of the UK (other than for holidays) or have you done so in the past 5 years? We will not usually accept applicants who have not been resident in the UK for the last 3 years. |
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| {!! $UnTip !!} | Have you been resident in the UK for the last 3 years? |
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| {!! $UnTip !!} | When would be the most convenient time for your medical tele-interview? Please select a convenient available date: | ||||
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