The Problem Gambling Prevention Data Collection System gathers feedback on your progress toward meeting the goals and outcomes in your Problem Gambling Prevention Implementation Plan.

Please make sure you select a response to each question, as each question is required to complete the survey.

Any questions regarding entering your quarterly data, please contact Roxann Jones at roxann.r.jones@state.or.us.

Thank you!

Question Title

* 1. Provider Name

Question Title

* 2. Reporting Period

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