NC Problem Gambling Program Baseline Gambling Questionnaire

Pre survey for all Staked Deck students.

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* 1. School or community organization name

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* 2. Today's Date

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* 3. Stacked Deck Instructor's Name (Your Teacher)

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* 4. Gender

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* 5. Date of birth, including year

Date / Time

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* 6. Mother's First Name

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* 7. The last TWO digits of your home phone or cell phone number

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* 8. Which best describes your belief about the benefit or harm that gambling has for society?

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* 9. Which of the following is true?

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* 10. How does gambling diff from older forms of gambling?

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* 11. In the United States and Canada, which of these is the most popular way to gamble? 

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* 12. Which of the following is least likely to happen to the average person this year?

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* 13. Gambling can become as addictive as drugs or alcohol

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* 14. Which of the following is associated with the highest rates of problem gambling?

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