Play Responsibly

Gender:

Male Female

Age:

Ethnic group

Monthly Income Group

Occupation:

i) Do you play above your limit?

Yes No Maybe

ii) Do you have the urge to bet more and try to win back the money you have spent?

Yes No Maybe

iii) Do you play as a way of getting out of financial difficulties?

Yes No Maybe

iv) Do you borrow to play?

Yes No Maybe

v) Does your debt increase due to betting?

Yes No Maybe

vi) Are you constantly thinking about playing other than for entertainment?

Yes No Maybe

vii) Do you feel guilty, anxious, frustrated or stressful due to gambling activities?

Yes No Maybe

viii) Do you gamble with money meant for essentials like food or rent?

Yes No Maybe

xi) Have you missed your daily or important responsibilities like work, studies, and family because of playing the games?

Yes No Maybe

x) Do you find it difficult to control, stop or cut down gambling?

Yes No Maybe