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Gaming/Therapy Survey
Please answer honestly and sincerely
* Indicates required question
Name
*
Your answer
Date of Birth
*
Your answer
How often do you play video games?
Less than once a week
At least once a week
Multiple times a week
Everyday, 1-2 hours
Everyday, Multiple hours a day
Weekends only
Other:
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What is your favorite game or game series?
Your answer
What gaming systems do you own?
PC
Xbox
Playstation
Nintendo Switch
Other:
Do you find games to be relaxing or helpful to destress?
Yes
No
Clear selection
Have you ever participated in therapy?
Yes
No
Clear selection
If no, have you ever thought about participating in therapy?
Yes
No
Maybe
Clear selection
Would playing a game during therapy interest you?
Yes
No
Maybe
Clear selection
If yes, what sorts of games would you want to play in therapy?
Your answer
If no, why would you not be interested in such therapy?
Your answer
If offered, would you be interested in a test session playing a game at no cost to you?
Yes
No
Maybe
Clear selection
Submit
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