yes no 1 Ever laughed at someone else’s misfortune? (1 point)
yes no 2 Ever laughed at a physically or mentally handicapped person? (2 points)
yes no 3 Ever tried alcohol? (1 point)
yes no 4 Ever been drunk? (2 points)
yes no 5 Ever play drinking games? (2 points)
yes no 6 Ever fall down because you drank too much? (3 points)
yes no 7 Ever drink enough to throw up? (4 points)
yes no 8 BONUS: Throwing up on yourself or another person (1 extra point)
yes no 9 Ever wake up and not remember what you did the night before (5 points)
yes no 10 Ever been forcibly removed from a bar? (8 points)
yes no 11 Ever participated in/finished a pub crawl? (5 points)
yes no 12 Do you drink regularly…at least 3 times a week? (3 points)
yes no 13 BONUS:…at least 4 times a week? (1 extra point)
yes no 14 BONUS:…at least 5 times a week? (1 extra point)
yes no 15 BONUS:…at least 6 times a week? (1 extra point)
yes no 16 BONUS:…at least 7 times a week? (1 extra point)
yes no 17 Ever fall asleep/pass out in a bar? (4 points)
yes no 18 Ever try pot? (4 points)
yes no 19 Ever try hash? (4 points)
yes no 20 Ever try magic mushrooms? (4 points)
yes no 21 Do you do drugs regularly? (4 points)
yes no 22 BONUS: 4 times a week? (4 extra points)
yes no 23 Ever bought “soft drugs”? (4 points)
yes no 24 Ever sell drugs? (8 points)
yes no 25 Ever sell drugs to support a drug habit? (12 points)
yes no 26 Ever use barbiturates? (8 points)
yes no 27 Ever use hallucinogens? {i.e.. LSD} (8 points)
yes no 28 Ever use narcotics? (10 points)
yes no 29 >Ever been stoned or drunk for more than 48 hours? (8 points)
yes no 30 Ever been on a date? (2 points)
yes no 31 Ever been felt up or groped? (2 points)
yes no 32 BONUS: Orgasm? (2 extra points)
yes no 33 Ever had sexual intercourse? (6 points)
yes no 34 BONUS: On the first date? (2 extra points)
yes no 35 Ever taken a bath or shower with someone of the opposite sex (5 points)
yes no 36 Ever paid for sex? (8 points)
yes no 37 Ever taken advantage of someone while they were stoned or drunk? (4 points)
yes no 38 Ever get someone stoned or drunk to obtain sexual favors and succeed? (8 points)
yes no 39 Ever engage in oral sex? (4 points)
yes no 40 BONUS: Orgasm? (2 extra points)
yes no 41 Ever engage in anal sex? (6 points)
yes no 42 BONUS: Orgasm? (2 extra points)
yes no 43 Ever engage in the 69 position? (4 points)
yes no 46 >Ever had or knowingly been responsible for an abortion? (12 points)
yes no 47 Ever have sex with two or more partners in a week? (4 points)
yes no 48 Ever had sex with more than one person at a time? (9 points)
yes no 49 Ever had sex in a public place? (6 points)
yes no 50 Ever had carpet burns in relation to a sexual act? (4 points)
yes no 51 Ever engage in sexual activity with a member of the same sex? (10 points)
yes no 52 Ever practiced bondage, masochism, or sadism for sexual gratification? (8 points)
yes no 53 Ever use sex toys? (6 points)
yes no 54 Ever pass out during sex? (5 points)
yes no 55 Ever been responsible for losing someone else’s virginity? (4 points)
yes no 56 Ever masturbated while talking on the phone? (3 points)
yes no >57 Ever bought anything in a sex shop? (3 points)
yes no 58 Ever lick or have someone lick your: Eyebal (1 point)
yes no 59 Ever lick or have someone lick your: Toes (2 points)
yes no 60 Ever lick or have someone lick your: Ears (1 point)
yes no 61 Ever have sex with a relative? (5 points)
yes no 62 Ever make someone sleep in the wet spot? (6 points)
yes no 63 Do necrophelia, pedophilia, and/or bestiality turn you on? (20 points)
yes no 64 Ever been arrested? (8 points)
yes no 65 BONUS: Convicted? (7 extra points)