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Name (Optional) : - Grade Level and Strand: - Age: - Sex

The document is a survey form designed to gather personal information and assess gaming habits among individuals. It includes sections for personal details, a list of popular games, and a series of questions rated on a scale from 1 to 4 regarding the impact of gaming on various aspects of life. Respondents are asked to evaluate how often gaming affects their concentration, responsibilities, and overall well-being.

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Dexter Salem
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67 views1 page

Name (Optional) : - Grade Level and Strand: - Age: - Sex

The document is a survey form designed to gather personal information and assess gaming habits among individuals. It includes sections for personal details, a list of popular games, and a series of questions rated on a scale from 1 to 4 regarding the impact of gaming on various aspects of life. Respondents are asked to evaluate how often gaming affects their concentration, responsibilities, and overall well-being.

Uploaded by

Dexter Salem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Part I.

Personal information
Name (optional):_______________________ Part III.
Grade level and strand:_______________
Age:__ Sex:____ Instruction: Kindly check response below.
Instruction: Kindly check 1 response below.
Part II. 1. What games you usually use?
Instruction: Rate each statement using the scale
given below. Check the box that corresponds to
your answer.
 Mobile legends
 Call of duty mobile
4 - Always  Roblox
 Block blast
3 - Usually
 Scatter
2 - Sometimes  Others:___________________
1 - Rarely

Questions: 4 3 2 1
1 When you are not gaming, how often
do you think about playing a game or
think about how would it feel to play
at that moment?
2 How often do you play games when
you should be sleeping?
3 How often do you lose concentration
on other task because you
preoccupied with gaming?
4 How often do you feel that you
should reduce the amount of time you
spend gaming?
5 How often do you feel that gaming
causes problems for you in your life?
6 How often do you neglect your
studies, work or other important
things because of your gaming?
7 How often do you neglect your tasks
at home in order to play games more?
8 how often do you lose track of time
when gaming?
9 How often do you neglect other
activities because you would rather
game?
1 How often do you lose concentration
0 on your homework because of
gaming?

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