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  1. Where do you most often access the internet?
    1. I never access the internet
    2. Home
    3. School
    4. Pay-for-use computer facility
    5. Community center
    6. Elsewhere
  2. How much time do you spend on the internet each week?
    1. None/Less than an hour
    2. 1 to 5 hours
    3. 5 to 10 hours
    4. More than 10 hours
  3. Have you ever done an internet search to help you with problems you are having at school, home or elsewhere?
    1. Yes
    2. No
  4. Does the information you read online help you to change or think about changing your behavior?
    1. Yes
    2. No

Please note: the questions listed are those that have been used in various custom modules to-date. These questions are intended to be used as guides only, as WestEd does not make claims to their utility. Clients wishing to develop a custom module should do so in consultation with their Cal-SCHLS Regional Center.

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