Name/ID#:
Date:
TIMELINE FOLLOWBACK CALENDAR: 2016
1 Standard Drink is Equal to
One 12 oz
can/bottle of
beer
One 5 oz glass of
regular (12%)
wine
1 mixed or straight
drink with 1 ½ oz
hard liquor
1 ½ oz of hard liquor
(e.g. rum, vodka,
whiskey)
Complete the Following
Start Date (Day 1):
End Date (yesterday):
MO
2016
SUN
DY
MON
YR
MO
TUES
WED
DY
THURS
FRI
1
J
3
4
A
10
11
N
F
2
5
6
7
8
9
12
13
14
15
16
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
4
5
6
9
10
11
12
13
16
17
18
19
20
23
24
25
26
27
1
2
3
4
5
8
9
10
11
12
7
8
Valentine’s Day
B
21
22
28
29
6
7
R
Chinese New Yr
SAT
18
14
A
New Year’s
17
E
M
M. Luther King
YR
13
Leap Year
14
20
27
15
President’s Day
Easter Sunday
15
16
17
St.Patrick’s Day
18
19
Good Friday
21
22
23
24
25
26
28
29
39
31
1
2
A
3
4
5
6
7
8
9
P
10
11
12
13
14
15
15
R
17
18
19
20
21
22
24
25
26
27
28
29
30
1
2
3
4
5
6
7
9
10
11
12
13
14
17
18
19
20
21
24
25
26
27
28
M
Mother’s Day
A
8
Y
15
16
22
23
29
30
Memorial Day
31
Passover
23
2
TLFB 2016
2016
SUN
J
5
U
12
N
19
26
26
Father’s Day
MON
TUES
WED
THURS
FRI
SAT
1
2
3
4
6
7
8
9
10
11
13
14
15
16
17
18
20
21
22
23
24
25
27
28
29
30
1
2
5
6
7
8
19
Independence Day
J
3
4
U
10
11
12
13
14
15
16
L
17
18
19
20
21
22
23
24
25
26
27
28
29
30
A
31
1
2
3
4
5
6
U
7
8
9
10
11
12
13
G
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
S
4
5
6
7
8
9
10
E
11
12
13
14
15
16
17
P
18
19
20
21
22
23
24
25
26
27
28
29
30
1
3
4
5
6
7
8
13
14
15
O
2
Rosh Hashanah
Yom Kippur
C
9
10
11
12
T
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
4
5
6
7
9
10
11
16
17
N
O
V
13
14
Halloween
8
Columbus Day
Election Day
15
Thanksgiving
Veterans’ Day
12
18
19
25
26
20
21
22
23
24
27
28
29
30
1
2
3
D
4
5
6
7
8
9
10
E
11
12
13
14
15
16
17
C
18
19
20
21
22
23
24
26
27
28
29
30
31
25
Christmas
Hanukkah
New Year’s Eve
2