| • |
Did you ever lose time from work due
to gambling? |
| • |
Has gambling ever made your home life unhappy? |
| • |
Did gambling affect your reputation? |
| • |
Have you ever felt remorse after gambling? |
| • |
Did you ever gamble to get money with which to
pay debts or otherwise solve financial difficulties? |
| • |
Did gambling cause a decrease in your ambition
or efficiency? |
| • |
After losing did you feel you must return as soon
as possible and win back your losses? |
| • |
After a win did you have a strong urge to return
and win more? |
| • |
Did you often gamble until your last dollar was
gone? |
| • |
Did you ever borrow to finance your gambling? |
| • |
Have you ever sold anything to finance gambling? |
| • |
Were you reluctant to use "gambling money"
for normal expenditures? |
| • |
Did gambling make you careless of the welfare
of yourself or your family? |
| • |
Did you ever gamble longer than you had planned? |
| • |
Have you ever gambled to escape worry or trouble? |
| • |
Have you ever committed, or considered committing,
an illegal act to finance gambling? |
| • |
Did gambling cause you to have difficulty in sleeping? |
| • |
Do arguments, disappointments or frustrations
create within you an urge to gamble? |
| • |
Did you ever have an urge to celebrate any good
fortune by a few hours of gambling? |
| • |
Have you ever considered self destruction or suicide
as a result of your gambling? |
| |
Source: Gamblers Anonymous |