Daily Routine Survey

1. What time do you usually wake up?

You can give only one answer.

○ Before 6 AM

○ 6-7 AM

○ 7-8 AM

○ After 8 AM

2. What activities do you usually do in the morning?

You can select several answers.

☐ Exercise

☐ Read

☐ Meditate

Other, type what

☐

3. What is your favorite breakfast?

4. How do you commute to work or school?

You can give only one answer.

○ Car

○ Public Transport
○ Bike

○ Walk

Other, type what

○

5. Rate your overall satisfaction with your daily routine on a scale of 1-5

Fill symbols.

6. How likely are you to recommend your daily routine to others?

Zdecydowanie nie polecę Zdecydowanie polecę

0 1 2 3 4 5 6 7 8 9 10

7. Rate each aspect of your morning routine on a scale

You can give only one answer in a row.

Poor Average Excellent

Time management
○ ○ ○

Productivity
○ ○ ○

Enjoyment
○ ○ ○

8. What time do you usually have lunch?

You can give only one answer.

○ Before 12 PM

○ 12-1 PM

○ 1-2 PM

○ After 2 PM
 9. What activities do you usually do in the afternoon?

You can select several answers.

☐ Work

☐ Study

☐ Exercise

Other, type what

☐

10. What is your favorite way to relax in the evening?

11. What time do you usually go to bed?

You can give only one answer.

○ Before 9 PM

○ 9-10 PM

○ 10-11 PM

○ After 11 PM

12. Rate your sleep quality on a scale of 1-5

Fill symbols.

13. Rate each aspect of your evening routine on a scale

You can give only one answer in a row.

Poor Average Excellent

Relaxation
○ ○ ○
 Poor Average Excellent

Preparation for the next day

○ ○ ○

Family time
○ ○ ○

14. What is one thing you would like to change about your daily routine?

15. How likely are you to recommend this survey to others?

Zdecydowanie nie polecę Zdecydowanie polecę

0 1 2 3 4 5 6 7 8 9 10