Frequency Assessment Survey
Please complete this survey to help us understand how frequently you engage in various activities or encounter certain experiences.
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
How often do you engage in the following activities?
*
Rows
Never
Rarely
Sometimes
Often
Always
Exercise or physical activity
1
2
3
4
5
Eat breakfast
6
7
8
9
10
Use digital devices (phone, computer, tablet)
11
12
13
14
15
Read for leisure
16
17
18
19
20
Socialize with friends or family
21
22
23
24
25
Go outdoors or spend time in nature
26
27
28
29
30
How frequently do you experience the following feelings or situations?
*
Rows
Never
Rarely
Sometimes
Often
Always
Feel stressed
31
32
33
34
35
Feel happy
36
37
38
39
40
Feel tired
41
42
43
44
45
Feel motivated
46
47
48
49
50
Feel overwhelmed
51
52
53
54
55
How satisfied are you with your current daily routine?
*
1
2
3
4
5
Which of the following activities do you do at least once a week? (Select all that apply)
Cook meals at home
Participate in sports or exercise
Watch television or streaming services
Volunteer or participate in community service
Other
Which time of day are you most active?
Morning
Afternoon
Evening
Night
Varies
Is there anything else you would like to share about your daily habits or routines?
Submit Survey
Should be Empty: