Gambling Survey

Yes	No	1. Have you ever lost time from work or school due to gambling?
Yes	No	2. Has gambling ever made you life unhappy?
Yes	No	3. Has gambling affected your reputation?
Yes	No	4. Have you ever felt guilty after gambling?
Yes	No	5. Have you ever gambled to get money to pay off debts?
Yes	No	6. Does gambling cause a decrease in your ambition or efficiency?
Yes	No	7. After losing do you feel like you must return ASAP to win back losses?
Yes	No	8. After a win do you have a strong urge to return and win more?
Yes	No	9. Have you gambled until your last dollar is gone?
Yes	No	10. Have you borrowed money to finance your gambling?

Yes	No	11. Have you sold anything to finance gambling?
Yes	No	12. Are you reluctant to use gambling money for expenditures?
Yes	No	13. Has gambling made you careless of your own welfare/that of your family?
Yeas	No	14. Have you ever gambled longer than planned
Yes	No	15. Have you ever gambled to escape worry or trouble?
Yes	No	16. Have you ever felt that you should stop gambling, but couldn't or wouldn't?
Yes	No	17. Has gambling caused you to have trouble sleeping?
Yes	No	18. Have you hid your gambling activity from others?
Yes	No	19. Have you ever claimed to win, even if you lose?
Yes	No	20. Have you ever considered harming yourself in any wau as a result of gambling?

If you have answered yes to 3 or more of the these questions, you may want to consider meeting with one of our faith based therapists at Family Foundations to discuss how gambling may be affecting you or your family.

How to Contact Us...