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Gambling Behaviors
1.
Have you bought lottery tickets?
YES
NO
2.
Have you played in a PA casino?
YES
NO
3.
Have you played a slot machine?
YES
NO
4.
Have you played bingo for cash prizes?
YES
NO
5.
Have you bet on sporting events or participated in sports pools?
YES
NO
6.
Have you bet on table games like poker, other card games, dice, backgammon or dominoes?
YES
NO
7.
Have you gambled online using a personal computer?
YES
NO
8.
In the past 30 days, how many days have you gambled?
0
1-4
5-10
11-15
16 or more
Other (please specify)
9.
In the past 30 days, how much money have you spent on gambling?
$0
$1-$20
$21-$50
$51-$100
$101-$200
$201-$400
$401 or more
Other (please specify)
10.
Has the money you spent on gambling ever led to financial problems?
YES
NO
11.
Has the time you spent gambling ever led to problems in your family, work or personal life?
YES
NO
12.
Does anyone in your family gamble?
YES
NO
13.
Do you know anyone who gambles?
YES
NO
14.
Does anyone in your family have a gambling problem?
YES
NO
15.
Do you know anyone who has a gambling problem?
YES
NO
16.
Do you know where to get information about getting help with a gambling problem?
YES
NO
17.
Have you ever seen an advertisement about where to get help for a gambling problem? If so, then what type was it?
YES
NO
TV Advertisement
Billboard
Bus shelter ad
ATM Receipt
Radio advertistement
18.
Zipcode
