The following is a quiz designed to give feedback on someone else's gambling behaviors and how this affects you. This is not a diagnosis and in no way replaces a formal assessment with a clinical professional. Your answers are kept completely confidential. No identifying information will be kept. Some information may be collected for research purposes.           1.   The gambler I am filling this out for is approximately:       Under 18 18-24 25-34 35-44 45-54 55-64 65 and older     2.   My relationship with the gambler is:       Husband/wife Significant other Parent Child Other family member Friend Employer Other     3.   The gambler I am filling this out for is:       Female Male     4.   I would describe the annual household income of the gambler I am filling this out for as:       Poverty Level Low moderate income Moderate income High moderate income High income           5.   The employment status of the gambler I am filling this out for is:       Full-time Homemaker Disabled Part-time Unemployed