Name/ID#:
Date:
TIMELINE FOLLOWBACK CALENDAR: 2015
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
2015
SUN
DY
MON
YR
MO
TUES
WED
THURS
1
J
4
5
A
11
12
N
M. Luther King
DY
New Year’s Day
YR
FRI
SAT
2
3
6
7
8
9
10
13
14
15
16
17
20
21
22
23
24
18
19
25
26
27
28
29
30
31
F
1
2
3
4
5
6
7
E
8
9
10
11
12
13
14
B
15
16
17
18
19
20
21
22
23
24
25
26
27
28
M
1
2
3
4
5
6
7
A
8
9
10
11
12
13
14
18
19
20
21
28
R
Pres. Day
St. Patrick’s Day
Chinese New Yr
15
16
17
22
23
24
25
26
27
29
30
31
1
2
3
6
7
8
9
10
11
Easter
Passover
4
Good Friday
A
5
P
12
13
14
15
16
17
18
R
19
20
21
22
23
24
25
26
27
28
29
30
1
2
4
5
6
7
8
9
11
12
13
14
15
16
19
20
21
22
23
26
27
28
29
30
M
3
A
10
Y
17
24
31
Mother’s Day
18
25
Memorial Day
Valentine’s Day
TLFB 2015
2
2015
SUN
MON
TUES
WED
THURS
FRI
SAT
1
2
3
4
5
6
8
9
10
11
12
13
15
16
17
18
19
20
22
23
24
25
26
27
28
29
30
1
2
3
4
J
5
6
7
8
9
10
11
U
12
13
14
15
16
17
18
L
19
20
21
22
23
24
25
26
27
28
29
30
31
1
A
2
3
4
5
6
7
8
U
9
10
11
12
13
14
15
G
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
4
5
8
9
10
11
12
14
15
16
17
18
19
23
24
25
26
J
7
U
14
N
S
21
Father’s Day
6
7
Rosh Hashanah
Labor Day
Independence Day
E
13
P
20
21
22
27
28
29
30
1
2
3
4
5
6
7
8
9
10
13
14
15
16
17
O
Columbus Day
Yom Kippur
C
11
12
T
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
5
6
7
12
13
14
20
21
27
28
N
Election Day
4
O
8
9
10
11
V
15
16
17
18
Veterans Day
19
Thanksgiving
22
23
24
25
26
29
30
1
2
3
4
5
7
8
9
10
11
12
19
Hanukkah
D
6
E
13
14
15
16
17
18
C
20
21
22
23
24
25
27
TLFB 2004
28
29
30
31
Christmas
Rosh Hashanah
Halloween
26
New Year’s Eve
2