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Do you spend time watching T.V/ Games/ other electronic devices?
 
Often
 
Sometimes
 
Rarely
 
Not often
 
Never
 
 
 
How old are you?
 
18+
 
16-17
 
14-15
 
Under 13.
 
 
 
How much time, if at all, do you spend on electronic devices?
 
8+ Hours
 
5-7 Hours
 
3-4 Hours
 
1-2 Hours
 
Never, I live off the grid.
 
 
 
What kind of electronics do you use most often?
 
Video Games
 
T.V
 
Social Media/ Phone
 
Computer
 
Other:___________________
 
None
 
 
 
Do you often use your electronic device past 9:00 PM?
 
Often
 
Sometimes
 
Rarely
 
Not often
 
Never
 
 
 
How many hours do you sleep?
 
8+
 
~7
 
~6
 
~5
 
Less than 4.
 
Never, i'm nocturnal.
 
 
 
How often is it that you have good sleep?
 
Often
 
Sometimes
 
Rarely
 
Not Often
 
Never
 
 
 
Do you toss and turn in the night?
 
Often
 
Sometimes
 
Rarely
 
Not often
 
Never
 
 
 
Do you use an electronic device to help you fall asleep?
 
Often
 
Sometimes
 
Rarely
 
Not often
 
Never
 
 
 
Do you keep this electronic device on while sleeping?
 
Often
 
Sometimes
 
Rarely
 
Not often
 
Never
 
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