Casino Survey
How much do you like to go to a casino?
1
2
3
4
5
How often do you go to a casino?
Every day
A few times a week
Once a week
A few times a month
Once a month or less
A few times a year or less
Once in a few years or less
Never
You prefer
Slot machines
Table games
None
Other
Please rate how strongly you agree or disagree with each of the statements regarding gambling.
Totally Disagree
Disagree
Agree
Totally Agree
N/A
I gamble for excitement.
1
2
3
4
5
Gambling is among the most enjoyable things for me.
6
7
8
9
10
Gambling can make me forget everything else for a while.
11
12
13
14
15
My gambling gives me friends.
16
17
18
19
20
I gamble for more money than I intended.
21
22
23
24
25
I gamble a longer time than intended.
26
27
28
29
30
I gamble when I should have done other things.
31
32
33
34
35
When gambling, I find it hard to stop.
36
37
38
39
40
My gambling is a way to make money.
41
42
43
44
45
When I win, it is due to my skill.
46
47
48
49
50
If I just gamble enough, my gambling will pay off.
51
52
53
54
55
Which one do you prefer in casinos?
Non-Banking table games.
Banking table games.
Electronic gaming tables
None
Other
When do you believe you will quit gambling?
Won $500
Won $400
Won $300
Won $200
Won $100
Lost $100
Lost $200
Lost $300
Lost $400
Lost $500
Not sure
Other
Your age belong to
Younger than 18
18-25
26-35
36-50
51-60
61 or older
Your Gender
Female
Male
Prefer not to answer
Other
Other notes/comments
Name (Optional)
First Name
Last Name
Email (Optional)
example@example.com
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