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Daily Life Routine Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
Start
Secured
Survio
1
What time do you usually wake up in the morning?
Please select the closest option to your waking up time.
Before 6 AM
6 AM - 7 AM
7 AM - 8 AM
After 8 AM
2
How would you rate your overall day so far?
Please rate your day on a scale of 1 to 10, where 1 is the lowest and 10 is the highest.
3
What is your main breakfast choice?
Please briefly describe what you usually have for breakfast.
4
How many meals do you typically have in a day?
Please select the number of meals you consume in a day.
1 meal
2 meals
3 meals
More than 3 meals
5
What time do you usually have lunch?
Please select the closest option to your typical lunchtime.
Before 12 PM
12 PM - 1 PM
1 PM - 2 PM
After 2 PM
6
Do you have a daily exercise routine?
Please indicate if you have a regular exercise regimen.
Yes
No
7
How do you usually unwind after a long day?
Please briefly describe how you relax and unwind at the end of the day.
8
On average, how many hours of sleep do you get per night?
Please provide the approximate number of hours you sleep each night.
9
What time do you typically go to bed at night?
Please select the closest option to your bedtime.
Before 10 PM
10 PM - 11 PM
11 PM - 12 AM
After 12 AM
10
How do you plan and organize your tasks for the next day?
Please briefly describe your method of planning and organizing your tasks for the upcoming day.
Continue
11
what is our condition
Select one or more answers
very good
good
bad
very bad
Submit