Gambling Behaviors Question Title * 1. Have you bought lottery tickets? YES NO Question Title * 2. Have you played in a PA casino? YES NO Question Title * 3. Have you played a slot machine? YES NO Question Title * 4. Have you played bingo for cash prizes? YES NO Question Title * 5. Have you bet on sporting events or participated in sports pools? YES NO Question Title * 6. Have you bet on table games like poker, other card games, dice, backgammon or dominoes? YES NO Question Title * 7. Have you gambled online using a personal computer? YES NO Question Title * 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) Question Title * 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) Question Title * 10. Has the money you spent on gambling ever led to financial problems? YES NO Question Title * 11. Has the time you spent gambling ever led to problems in your family, work or personal life? YES NO Question Title * 12. Does anyone in your family gamble? YES NO Question Title * 13. Do you know anyone who gambles? YES NO Question Title * 14. Does anyone in your family have a gambling problem? YES NO Question Title * 15. Do you know anyone who has a gambling problem? YES NO Question Title * 16. Do you know where to get information about getting help with a gambling problem? YES NO Question Title * 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 Question Title * 18. Zipcode Done
