Brief Biosocial Gambling Screen
(BBGS)
Name
*
Email
*
example@example.com
Date
*
/
Month
/
Day
Year
Date
1. During the past 12 months, have you become restless irritable or anxious when trying to stop/cut down on gambling?
*
• Yes
• No
2. During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?
*
• Yes
• No
3. During the past 12 months did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends or welfare?
*
• Yes
• No
Submit
Should be Empty: