Background <p>Few primary care patients with hazardous drinking initiate or engage in alcohol care. We conducted a formative evaluation of an intervention, Connect to Care (C2C), designed to support patients with hazardous drinking and mental health symptoms in initiating alcohol care.</p> Objective <p>C2C’s acceptability and barriers and facilitators to its use in the primary care setting were explored.</p> Design <p>Participants were enrolled in a pilot randomized controlled trial of C2C. Participants assigned to the C2C condition were selected to participate in a qualitative interview at the completion of their 3-month follow-up. Template analysis was used to analyze qualitative data.</p> Participants <p>We interviewed 20 primary care patients (90% male) with a positive screen for hazardous drinking and depression and/or PTSD symptoms.</p> Key Results <p>Participants described four ways that C2C was helpful: Using a menu, the coach helped educate participants on their alcohol care options; participants’ felt that the coach was non-judgmental, caring, and genuinely interested in helping them learn about their care options and link them to their preferred option; participants’ appreciated the flexibility of how and when C2C was offered which facilitated engagement; and it was some participants’ perception that C2C helped them reduce both their alcohol use and mental health symptoms. However, some patients reported that the length of C2C sessions, repetitive information provided by the coach, and not wanting to change their drinking habits as barriers to C2C session attendance.</p> Conclusions <p>This qualitative study highlights helpful components, potential barriers to session attendance, and potential adaptations to C2C informed by primary care patients participating in a pilot RCT of this strengths-based intervention. The findings could help inform implementation of C2C in the primary care setting.</p>