Media Questionnaire Form
Share your media preferences and habits to help us better understand your media consumption experience. All responses are confidential.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age Group
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Which types of media do you consume regularly?
*
Television
Online News
Podcasts
Social Media
Radio
Print Newspapers/Magazines
Streaming Video
Other
How often do you consume media?
*
Multiple times a day
Once a day
A few times a week
Once a week
Less than once a week
What devices do you primarily use for media consumption?
*
Smartphone
Tablet
Laptop/PC
Smart TV
Radio
Other
Which sources or platforms do you trust most for news and information?
What motivates you to consume media?
*
Stay informed
Entertainment
Education
Social connection
Pass the time
Other
How satisfied are you with your current media options?
1
2
3
4
5
Please share any additional comments or suggestions about your media experience.
Submit
Should be Empty: