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Screening Tool
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1.
Have there ever been periods lasting 2 weeks or longer when you spent a lot of time thinking about your gambling experiences, planning out future gambling ventures, bets, or thinking about ways to get money to gamble with?
(Required.)
Yes
No
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2.
Have there ever been periods when you needed to gamble with increasing amounts of money with larger bets than before in order to get the same feeling of excitement?
(Required.)
Yes
No
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3.
Have you ever felt restless or irritable when trying to stop, cut down, or control your gambling?
(Required.)
Yes
No
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4.
Have you ever tried and not succeeded in stopping, cutting down, or controlling your gambling 3 or more times in your life?
(Required.)
Yes
No
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5.
Have you ever gambled to escape from personal problems, or to relieve uncomfortable feelings such as guilt, anxiety, helplessness, or depression?
(Required.)
Yes
No
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6.
Has there ever been a period when, if you lost money gambling one day, you would often return another day to get even?
(Required.)
Yes
No
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7.
Have you lied to family members, friends, or others about how much you gamble, and/or about how much money you lost on gambling, on at least 3 occasions?
(Required.)
Yes
No
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8.
Have you ever written a bad check or taken money that didn’t belong to you from family members, friends, or anyone else in order to pay for your gambling?
(Required.)
Yes
No
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9.
Has your gambling ever caused serious or repeated problems in your relationships with any of your family members or friends? Or, has your gambling ever caused you problems at work or your studies?
(Required.)
Yes
No
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10.
Have you ever needed to ask family members, friends, a lending institution, or anyone else to loan you money or otherwise bail you out of a desperate money situation that was largely caused by your gambling?
(Required.)
Yes
No
11.
If you answered "yes" to any of these questions
or would like more information about problem gambling, please contact Jessica at Prevention Network by calling 315-471-1359 or enter your email and/or phone number below and she will reach out.
To reach the Central Problem Gambling Resource center for treatment services available, please call (315) 413-4676 or email centralpgrc@nyproblemgambling.org.
