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Questionnaire template

Technology Access and Use

Assesses people's tech skills, device and internet access, main apps, troubleshooting confidence and daily screen time.

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Questions in this template

Your Skills and Devices

  1. This survey asks about the devices, internet connection and software you use. Your answers help us plan the right technology support.

  2. How would you describe your skill with technology?

    Choose one:

    • Beginner
    • Intermediate
    • Advanced
    • Expert
  3. Can you use each of these devices when you need to?

    • Desktop computer
    • Laptop
    • Smartphone
    • Tablet

    For each row: choose one:

    • Yes, my own
    • Yes, shared with others
    • No

Internet Access

  1. How would you rate the internet connection where you live?

    Choose one:

    • Excellent
    • Good
    • Fair
    • Poor
    • I have no internet access at home
  2. Which of these problems do you run into regularly?

    Condition: Shown to respondents with home internet

    Choose any that apply:

    • Slow speed
    • Dropped connections
    • Service outages
    • Data limits
    • None of these
  3. Please describe how these problems affect you.

    Condition: Shown when at least one problem was selected

    Open answer

Software and Apps

  1. Which software programs or apps do you use most? List up to three.

    Open answer

Confidence and Time Spent

  1. How confident are you in solving technical problems on your own?

    Choose one:

    • Very confident
    • Somewhat confident
    • Not very confident
    • Not at all confident
  2. What kind of help would make you more confident?

    Condition: Shown to respondents who are not confident

    Open answer

  3. On a typical day, about how many hours do you spend using computers, phones or other devices?

    A number from 0 to 24