Compulsive gamblers usually answer "yes" to at least seven of the twenty questions. If you answered yes to seven or more, complete and submit this form. One of our counselors will be in touch with information about our program. Submitting this form does not obligate you to participate in any way.
Our counselors are happy to visit with you by phone or email. If you'd prefer, they are also happy to send literature by mail. Please leave your phone number, email or mailing address, so that we can follow up.