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The Self Survey "Twenty Questions"

Important: If you are currently having feelings or thoughts about suicide, please immediately call either:

• National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255)
• National Hopeline Network 1.800.SUICIDE (1.800.784.2433) .

Depression is treatable. Suicide can be prevented. Problem gambling help is available to California residents at 1-800-GAMBLER (1-800-426-2537).

All information entered in the following survey is Confidential!

Did you ever lose time from work or school due to gambling?	Yes	No
Has gambling ever made your home life unhappy?	Yes	No
Did gambling affect your reputation?	Yes	No
Have you ever felt remorse after gambling?	Yes	No
Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?	Yes	No
Did gambling cause a decrease in your ambition or efficiency?	Yes	No
After losing, did you feel you must return as soon as possible and win back your losses?	Yes	No
After a win, did you have a strong urge to return and win more?	Yes	No
Did you often gamble until your last dollar was gone?	Yes	No
Didyou ever borrow to finance your gambling?	Yes	No
Have you ever sold anything to finance gambling?	Yes	No
Were you reluctant to use "gambling money" for normal expenditures?	Yes	No
Did gambling make you careless of the welfare of yourself and your family?	Yes	No
Did you ever gamble longer than you had planned?	Yes	No
Have you ever gambled to escape worry or trouble?	Yes	No
Have you ever committed, or considered committing, an illegal act to finance gambling?	Yes	No
Did gambling cause difficulty in sleeping?	Yes	No
Do arguments, disappointments or frustrations create within you an urge to gamble?	Yes	No
Did you ever have an urge to celebrate any good fortune by a few hours of gambling?	Yes	No
Have you ever considered self destruction or suicide as a result of your gambling?	Yes	No

"Most compulsive gamblers will answer yes to at least seven of these questions." (Gamblers Anonymous)

(Survey source: Gamblers Anonymous Fellowship)