Red7

Written by:
Lauren Harrison

Checked by:
Alex Tester

	Updated on:

November 8th, 2023

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Blank Form (#4)

Do you often gamble when feeling distressed?

Yes

No

Have you lied about your gambling habit or tried to hide gambling activities?

Yes

No

Do you need to gamble with increasing amounts to achieve the desired excitement?

Yes

No

Are you restless or irritable when trying to cut down or stop gambling?

Yes

No

Do you have frequent thoughts about gambling (such as reliving past gambling or planning future gambling)?

Yes

No

Have you risked or lost a close relationship, a job, or a school or job opportunity because of gambling?

Yes

No

Have you experienced repeated unsuccessful efforts to control, cut back on, or stop gambling?

Yes

No

Do you rely on others to help with money problems caused by gambling?

Yes

No

After losing money gambling, do you try to recoup your losses, referred to as chasing losses?

Yes

No