MAST Score Form Name(Required) First Last Date assessment was conducted:(Required) MM slash DD slash YYYY Counselor Name(Required) Score one point if they answered the following: 1. No 2. Yes 3. Yes 4. No 5. Yes 6. Yes 7 through 22: Yes Then, add up the scores and compare to the following score card: 1 – 4 points: Non-Alcoholic 5 – 6 points: Suggests Alcoholism 7 or more points: Indicates Alcoholism Results of Assessment(Required)Were the results of the assessment discussed with participant?(Required) Yes No Comments(Required)
