Gambling Survey

Brief Biosocial Gambling Screen

Question Title

* 1. During the past 12 months, have you become restless, irritable or anxious when trying to stop/cut down on gambling?

Yes

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* 2. During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?

Yes

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* 3. During the past 12 months, did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends or welfare?

Yes

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* 4. Please select the option that best describes how you feel right now:

I never think about my gambling.

Sometimes I think about gambling less.

I have decided to gamble less.

I am already trying to cut back on my gambling.

I changed my gambling. I now do not gamble, or gamble less than before.

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* 5. Please enter your zip code and email address. (*Required to receive a $6 Subway e-gift card.)

ZIP/Postal Code

Email Address

Thank you for completing the Brief Biosocial Gambling Screen. You will receive an email shortly with your Subway coupon and feedback on your survey. If you have questions please contact info@cpsummit.org.

Answering "yes" to one of the previous questions indicates that, currently, you are at increased risk for developing or experiencing gambling-related problems. You are not alone. About 1% of adults and 5% of college students report that they have experienced a severe gambling-related problem during their lifetime. Gambling-related problems can take a variety of forms, including money problems, relationship problems, health problems, school problems, and more.

In the survey, you may have indicated that you are thinking about reducing your gambling behavior. The decision to gamble, reduce your gambling or just stop gambling is yours. If you want to change your gambling behavior, you can. To help you make your decision and, if you choose, to help you reduce your gambling, you might want to do a more detailed self-assessment of your gambling behavior. Gambling-related problems can be severe. If you or someone you know is suffering from a gambling-related problem, consider talking to someone about it. Please call the Ohio Problem Gambling Hotline at 1.800.589.9966 for direction to local resources.