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What is your gender
 
Male
 
Female
 
Other
 
 
 
Which category below includes your age?
 
17 or younger
 
18-24
 
25-29
 
30-35
 
36-39
 
40 or older
 
 
 
Do you own a cell phone or smart phone?
 
Cell Phone
 
Smart phone
 
No Phone
 
 
 
Do you have a cell phone with texting capabilities or access to one?
 
Yes
 
No
 
 
 
What is the main use of your cell or smart phone? (Check any that apply)
 
Keeping in touch with family and friends
 
Browsing the internet
 
School relates activities
 
Work/ business related activities
 
Getting the news and information
 
Playing games

 
 
 
How many hours per day do you spend texting?
 
Less than 1hr
 
1-2hr
 
3-4hr
 
5-6hr
 
More than 7hr
 
 
 
How many hours per day you spend talking on the phone?
 
Less than 1hr
 
1-2hr
 
3-4hr
 
5-6hr
 
More than 7hhr
 
 
 
What form of communication do you mostly use on a daily basis with friends and family members? (check any that apply)
 
In person
 
Phone Call
 
Text Messaging
 
Email
 
Instant Messaging
 
voice over internet (i.e. Skype)

 
 
 
Have you ever ended an intimate relationship by sending a text message?
 
Yes
 
No
 
 
 
Has someone ever ended an intimate relationship with you by sending a text?
 
Yes
 
No
 
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