1. Do you lose time from work or school due to gambling?
2. Is gambling making your home life unhappy?
3. Is gambling affecting your reputation?
4. Have you ever felt remorse after gambling?
5. Do you ever gamble to get money with which to pay debts or to otherwise solve financial difficulties?
6. Does gambling cause a decrease in your ambition or efficiency?
7. After losing, do you feel you must return as soon as possible and win back your losses.
8. After a win do you have a strong urge to return and win more?
9. Do you often gamble until your last dollar is gone?
10. Do you ever borrow to finance your gambling?
11. Have you ever sold anything to finance gambling?
12. Are you reluctant to use gambling money for normal expenditures?
13. Does gambling make you careless of the welfare of your family?
14. Do you gamble longer than you planned?
15. Do you ever gamble to escape worry or trouble?
16. Have you ever committed, or considered committing, an illegal act to finance gambling?
17. Does gambling cause you to have difficulty in sleeping?
18. Do arguments, disappointments, or frustrations create an urge within you to gamble?
19. Do you have an urge to celebrate any good fortune by a few hours gambling?
20. Have you ever considered self-destruction as a result of your gambling?
