Alcohol Innerview is a brief, online alcohol abuse prevention and harm reduction program.  The Alcohol Innerview program involves a 15-20 minute online assessment of alcohol use with personally tailored recommendations for making change and reducing risk around alcohol use.  Students also have option to voluntarily follow-up with a member of the Alcohol and Drug Education program to discuss their program results and make further goals for change.  The Alcohol Innerview program is presented in a non-confrontational manner that enables students to make their own informed decisions regarding their alcohol use. 

Alcohol Innerview Registration Form

IMPORTANT: Please be certain of your referral before proceeding. This registration form is to be used for Alcohol Innerview only.  To register for Alcohol Innerview, please complete the form below. Within approximately one week, you will be contacted with further instructions.

PLEASE NOTE: There is NO FEE for this program.  For questions about registering for Alcohol Innerview, please contact us at 617-552-0243.

All fields are required for registration.
Your Full Name
Email Address
Local Address
Eagle ID#
Phone
Referred By
"Complete By" Date
If you are interested in the voluntary one on one follow-up, please indicate your availability with a two-hour meeting range for each date you are available.	Monday between        time 10am 11am 12pm 1pm 2pm 3pm  and   time 12pm 1pm 2pm 3pm 4pm 5pm Tuesday between        time 10am 11am 12pm 1pm 2pm 3pm  and  time 12pm 1pm 2pm 3pm 4pm 5pm Wednesday between  time 10am 11am 12pm 1pm 2pm 3pm  and  time 12pm 1pm 2pm 3pm 4pm 5pm Thursday between       time 10am 11am 12pm 1pm 2pm 3pm  and   time 12pm 1pm 2pm 3pm 4pm 5pm Friday between       time 10am 11am 12pm 1pm 2pm 3pm  and   time 12pm 1pm 2pm 3pm 4pm 5pm
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