Digital Cooldown Prototype Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill in this short survey to see whether you would be suitable for testing the Digital Cooldown app.

Do you feel as if your online habits impact your wellbeing?

Yes

Not sure

Clear selection

On a scale of 1-10 how healthy would you say your relationship is with the internet? (1 = terrible. 10 = amazing)

Select your biggest/most annoying tech problem(s):

Social media in general (excluding messaging apps, like WhatsApp)

I feel “addicted” to my smartphone

Lack of focus and productivity

I feel as if I spend too much time consuming media instead of doing what I love

Checking work email/Slack or other work-related tasks

I no longer feel creative

It has a negative impact on my relationships with others

It makes me feel anxious, low or not good enough

I have no problem

Other:

Can you commit 5-10 minutes a day for up to 7 days (self-led) across 2 weeks?

Yes

Clear selection

Job Title:

Name:

Email (this is where instructions and the test link will be sent)

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Digital Cool Down. Report Abuse