Disclaimer: As a collaborative effort between the Office of the Governor – Substance Abuse & Rehabilitation (SAR) Program, Commonwealth Casino Commission (CCC), and Imperial Pacific International (IPI), this survey will help determine if further comprehensive screening tool or assessment is appropriate in regards to problem gambling in the CNMI. The need for treatment services will also be better understood from such survey.

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* 1. What is your gender?

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* 2. What is your ethnicity? (Please select only one)

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* 3. What is your age?

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* 4. Village

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* 5. Do you participate in any type of gambling? (Please select all that apply.)

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