This free survey is powered by QUESTIONPRO.COM
  1. Surveys
  2. 2003
  3. April
  4. D
  5. Dissertation Survey
0%
 
 
* School Name:
   
 
 

6 7 8 9 10 11 12
* Current Grade:
 
 

F M T
Sex:
 
 
 
Height:
   
 
 
 
Weight:
   
 
 

School Laptop Make:
Toshiba Dell IBM Compaq Other  
 
 
 
School Laptop Model (if known):
   
 
 

Do you use a computer at home other than your laptop?
Yes No
 
 

PC / desktop laptop other
If YES, what type of home computer do you use?
 
 
Do you use the internet?
 
 
Yes
 
No
 
 

Where do you usually access the internet?
 
Home
 
School
 
Library
 
Friend's house
 
Other
 
 
 

30 minutes or less 1hr. 1hr. 30min. 2hr. 2hr. 30min. 3hr. 3hr. 30min 4hr. 4hr. 30min. 5hr. 5 hours or more
Approximately how many hours per DAY do you spend online?
 
 

Have you ever experienced any pain or discomfort while using a computer or playing an electronic game?
 
Yes
 
No
 
Comment:
 
 
 

Did you see any type of medical professional regarding the pain you felt while working on your computer?
 
Yes
 
No
 
Comment:
 
 
 

Do you regularly play a muscial insturment? If YES, which?
Yes No Instrument(s):  
 
 

30 minutes or less 1hr. 1hr. 30min. 2hr. 2hr. 30min. 3hr. 3hr. 30min 4hr. 4hr. 30min. 5hr. 5 hours or more
Approximately how many hours per day do you spend playing your instrument?
 
 

Do you regularly play sports? If YES, which?
Yes No Sports:  
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
Approximately how many hours per WEEK do you spend playing sports?
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more Do not watch TV during the week
Approximately how many hours per DAY do you spend watching TV?
 
 

Pager Cellular phone PDA (ie. Palm Pilot) Portable text messenger (ie. Blackberry Handheld electronic games (ie. Gameboy) TV linked game system (ie Game Cube / Nintendo 64) None
Which of the following items do you own or use regularly?
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
Approximately how many hours per WEEK do you spend playing a TV game system? (like Nintendo or SEGA)
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
Approximately how many hours per WEEK do you spend playing portable electronic games? (like Gameboy or Game Gear)
 
 

Approximately how many text messages do you send from a portable device each WEEK?
 
None
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
31-40
 
41-50
 
50+

 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
* Approximately how many hours per DAY do you work on your laptop AT school?
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
* Approximately how many hours per DAY do you work on your laptop AFTER school?
 
 

30 min. or less 1-2 hrs. 2-3 hrs. 3-4 hrs. 4-5 hrs. 5-6 hrs. 6-7 hrs. 7-8 hrs. 8-9 hrs. 9-10 hrs. 10 hrs. or more
Approximately how many hours per DAY do you work on a PC/desktop computer AFTER school?
 
 

Do you ever experience pain or discomfort carrying your laptop?
 
Yes
 
No
 
Comment:
 
 
 

Do you ever experience pain or discomfort carrying your school bag/backpack (without your laptop)?
 
Yes
 
No
 
Comment:
 
 
 

If YES, where did you feel pain, ache, or discomfort?
 
Neck
 
Shoulder
 
Upper back
 
Upper arm
 
Lower back
 
Forearm
 
Wrist
 
Hip / Buttocks
 
Thigh
 
Knee
 
Lower leg
 
Eyes
 
Other:
 

 
 

Did you stop playing or working when you felt discomfort?
 
Yes
 
No
 
Comment:
 
 
 

Did a medical professional examine the body part that hurt while you used your computer or played on your TV game system?
 
Yes
 
No
 
Comment
 
 
 
Select all that apply.
Where do you usually use your laptop?
 
Sitting at a desk
 
Sitting on the floor
 
Outside
 
At a cafe
 
In front on the TV
 
In the car
 
On the bus
 
At a friend's house
 
At the library
 
School
 
Most common location & Other:
 

 
 

When using your laptop, do you ever attach an external keyboard or mouse?
 
Yes, a keyboard
 
Yes, a mouse
 
Yes, both
 
No.
 
Comment:
 
 
 
Select all that apply.
How do you like to position the laptop when using it?
 
On a desk
 
On the floor
 
On your legs
 
On a coffeetable
 
Favorite Position or Other:
 
 
 

How many books and binders do you usually carry in your school bag each day?
 
0-1
 
2-3
 
4-5
 
6-7
 
8-9
 
10+
 
How much do you think your school bag weighs?
 
 
Please contact [email protected] or click here if you have any questions regarding this survey.
Survey Software Powered by QuestionPro Survey Software