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
This survey asks about the devices, internet connection and software you use. Your answers help us plan the right technology support.
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How would you describe your skill with technology?
Choose one:
- Beginner
- Intermediate
- Advanced
- Expert
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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
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How would you rate the internet connection where you live?
Choose one:
- Excellent
- Good
- Fair
- Poor
- I have no internet access at home
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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
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Please describe how these problems affect you.
Condition: Shown when at least one problem was selected
Open answer
Software and Apps
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Which software programs or apps do you use most? List up to three.
Open answer
Confidence and Time Spent
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How confident are you in solving technical problems on your own?
Choose one:
- Very confident
- Somewhat confident
- Not very confident
- Not at all confident
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What kind of help would make you more confident?
Condition: Shown to respondents who are not confident
Open answer
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On a typical day, about how many hours do you spend using computers, phones or other devices?
A number from 0 to 24