Consent Form

You are invited to participate in a web-based online survey on the impact of total screen-time usage on mental health. This is a research project being conducted by Nick Xiong, a student at Alliant International University. It should take approximately 15 minutes to complete. The survey will include questionnaires to assess your overall time spent on screen-time devices, and which devices you use. You will also be asked to complete questionnaires to indicate your current level of depression, anxiety, stress, and internet addiction level.

Your participation in this survey is voluntary. You may refuse to take part in the research or exit the survey at any time without penalty. You are free to decline to answer any particular question you do not wish to answer for any reason.

You will receive no direct benefits from participating in this research study. However, your responses may help us learn more about the impact total scree-time use has on overall mental health, specifically how it affects depression, anxiety, and stress in adults. 

The possible risks or discomforts of the study are minimal. You may feel a little uncomfortable or embarrassed by answering personal survey questions.

Your survey answers will be stored in a password protected electronic format. According to SurveyMonkey's Privacy Policy (, personal data collected from the survey may be transferred to various countries, including the United States and other locations SurveyMonkey has offices. However, the researcher will not share or disclose of survey information. 

If you have questions at any time about the study or the procedures, you may contact my dissertation chair, Dr. Matthew Baity Ph.D. via email at

For general questions about rights of research participants contact the Alliant International University Institutional Review Board at

“Approved by Alliant International University Institutional Review Board”.

ELECTRONIC CONSENT: Please select your choice below. You may print a copy of this consent form for your records. Clicking on the “Yes” button indicates that:

Question Title

* 1. You have read the above information
You voluntarily agree to participate
You are 18 years of age or older

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