SURVEY FORM

This questionnaire will gather some information about your personal background.
Please supply the needed information.

PERSONAL DATA:

Name (Optional):
Sex:__________
grade level:_______________
Age:__________

DIRECTION: Put a check (√ ) of your corresponding choices. Your answer will be

treated confidentially. Thank you!

Choose top 5 mobile games that you playing

Mobile Legend

Clash of Clans

PUBG

Word scape

Call of Duty

Rules of Survival

Candy Crush

NBA 2k

Mine Craft

4 Pic 1 Word
 A. Health Agree Strongly Neutral Disagree Strongly
Agree Disagree
I lack of sleep because of mobile
gaming

My back is aching when I spend too

much Playing

I can’t eat on time because of playing

games

It reducing depression and

decreasing stress

Gaming is helping to fight certain

health problems

B. cognitive
Decision Making

My hand-eye coordination

Mobile game improve the brain

Improving certain skills and keeping

the mind sharp

Playing mobile games can help to

keep anxiety and promote relaxation

B. Social
I don’t have time to bond with my
family

I play games to communicate with

other players

I have many friends because of

playing

Increased social interaction from

games

Help you build confidence and

concentration