Sleep Study Entrance Survey

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Thanks for your interest in my Sleep Study! Please complete the information below. Answering these questions will help me establish a starting point for you. Please make sure to list your complete mailing address to ensure you receive necessary study materials. The email address you provide here will be used for communicating with you about the study, so please include an address that you access regularly. There will be another survey at the end of the study. These answers will not be shared with anyone. Information may be used to make anonymous tallies (for example, of the X number of participants, Y slept less than 4 hours before starting the study.).

What is your name (First and Last)? *

What is your email address? *

Are you 18 years old or older? *

Yes

What is your mailing address? *

What time do you go to sleep most nights? *

Time

How many hours do you sleep each night, on average? *

Less than 4

Between 4 and 5 hours

Between 5 and 6 hours

Between 6 and 7 hours

Between 7 and 8 hours

More than 8 hours

Other:

I require an alarm clock to wake up. *

Yes, and I need to hit snooze at least once.

Yes, but I don't need to hit snooze.

No, I wake up on my own.

No, something else wakes me up.

Other:

If something else wakes you, what is it? *

Child/children

I need to use the bathroom

Pet(s)

Significant other

Other:

How do you feel when you wake up? *

Refreshed, ready to start my day.

Still tired, like I need more sleep.

I need caffeine before I feel awake.

Other:

Thanks for your participation! You will receive additional information about the study at the email address above. Please enter today's date. You may watch the video below now or save it for later. Please complete the survey by answering the last question below the video. *

YYYY

Feel free to watch this short video (approximately 22 minutes) at your leisure. I think you may find it interesting!

Submit survey here. *

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