Templates/Screen Time Survey

Screen Time Survey

Anonymous multi-step poll about screen habits with live results dashboard

pollmulti-stepdarkanonymous
Live Form — try submittingView source →

Dashboard Preview

Sample data — this is what the auto-generated dashboard looks like when you create this form with createDashboard: true.

Total Submissions

25

Recent Submissions

screen_timeprimary_activityprimary_devicebefore_bedtoo_muchSubmitted
Less than 2 hoursSocial mediaPhoneAlwaysDefinitely yes
2-4 hoursWorkLaptopOftenProbably yes
4-6 hoursGamingDesktopSometimesNot sure
6-8 hoursStreamingTabletRarelyProbably no
8+ hoursNewsPhoneNeverDefinitely no

Use this template

Use standalone

Download the HTML file and serve it anywhere. It already submits to Sutrena out of the box — or swap the endpoint for your own backend.

Deploy with one command

Get a hosted form with a live dashboard in seconds:

curl -s sutrena.com/api/trial -d '{"email":"[email protected]"}' | jq -r .key | xargs -I{} curl -s sutrena.com/api/forms -H "Authorization: Bearer {}" -d '{"templateId":"survey","createDashboard":true}'

For AI agents

Deploy this template as a hosted form with one API call:

curl -X POST https://sutrena.com/api/trial
# → {"key":"st_trial_xxx"}

curl -X POST https://sutrena.com/api/forms \
  -H "Authorization: Bearer st_trial_xxx" \
  -H "Content-Type: application/json" \
  -d '{
  "templateId": "survey",
  "createDashboard": true
}'
Custom fields from this template
[
  {
    "name": "screen_time",
    "label": "Daily screen time",
    "type": "select",
    "required": true,
    "options": [
      "Less than 2 hours",
      "2-4 hours",
      "4-6 hours",
      "6-8 hours",
      "8+ hours"
    ]
  },
  {
    "name": "primary_activity",
    "label": "Primary activity",
    "type": "select",
    "required": true,
    "options": [
      "Social media",
      "Work",
      "Gaming",
      "Streaming",
      "News",
      "Other"
    ]
  },
  {
    "name": "primary_device",
    "label": "Primary device",
    "type": "select",
    "required": true,
    "options": [
      "Phone",
      "Laptop",
      "Desktop",
      "Tablet"
    ]
  },
  {
    "name": "before_bed",
    "label": "Screen use before bed",
    "type": "select",
    "required": true,
    "options": [
      "Always",
      "Often",
      "Sometimes",
      "Rarely",
      "Never"
    ]
  },
  {
    "name": "too_much",
    "label": "Do you think you spend too much time on screens?",
    "type": "select",
    "required": true,
    "options": [
      "Definitely yes",
      "Probably yes",
      "Not sure",
      "Probably no",
      "Definitely no"
    ]
  }
]
Screen Time Survey — Form Template — Sutrena | Sutrena