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THE PROBLEM GAMBLING COALITION OF COLORADO VOLUNTARY CASINO SELFEXCLUSION APPLICATION AND WAIVER Please print clearly (Illegible or incomplete forms will be returned and will require resubmission):
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Obtain the form from the Problem Gambling Coalition
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Fill out personal information such as name, address, and contact details
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Provide detailed information about gambling habits and any issues related to problem gambling
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Who needs form problem gambling coalition?

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Individuals who are seeking help or support for problem gambling
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The Form Problem Gambling Coalition is a document utilized by organizations and entities involved in gambling to report their efforts and contributions towards addressing problem gambling within their communities.
Organizations that engage in gambling operations, such as casinos, gaming agencies, and other related entities, are typically required to file the Form Problem Gambling Coalition.
To fill out the Form Problem Gambling Coalition, organizations must provide detailed information regarding their gambling programs, resources allocated for problem gambling prevention, and any partnerships with help services.
The purpose of the Form Problem Gambling Coalition is to promote responsible gambling practices, report on problem gambling prevention efforts, and ensure compliance with state regulations aimed at reducing the impact of gambling addiction.
Information that must be reported includes the organization's name, the nature of their gambling activities, financial contributions to problem gambling support, and details on outreach and education initiatives related to responsible gambling.
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