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Caffeine Use Disorder Survey

Caffeine is used in educational institution so Cabs will be used for there behiovar and attempting self harm

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sana kakar
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424 views2 pages

Caffeine Use Disorder Survey

Caffeine is used in educational institution so Cabs will be used for there behiovar and attempting self harm

Uploaded by

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

Questions for Caffeine Use Disorder

Survey
Questions

1. How much caffeine do you consume on a daily basis?


The answer should be a text input.

2. How often do you consume caffeine?


The answer should be a text input.

3. What are the reasons you consume caffeine?


The answer should be a text input.

4. Do you experience any negative side effects from caffeine consumption?


The answer should be a single choice:
a. Yes
b. No
c. Unsure

5. Do you feel like you need to consume caffeine in order to function properly?
The answer should be a single choice:
a. Yes
b. No
c. Unsure

6. Has your caffeine consumption ever interfered with your work or social life?
The answer should be a text input.

7. Do you think you may be dependent on caffeine?


The answer should be a single choice:
a. Yes
b. No
c. Unsure

8. Would you like to cut back on your caffeine consumption?


The answer should be a text input.

9. What are your thoughts on caffeine?


The answer should be a text input.

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