Digital Skills Assessment / In-Take Form

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The purpose of this form is to get a general idea of our community member's comfort with technology.
OpenHub is working with other Digital Navigators in the Hudson Valley, NY to assess the needs, and uses Digital Navigators Framework from National Digital Inclusion Alliance.
This project was made possible in part by the Institute of Museum and Library Services grant number LG-248566-OLS-20.

Don’t spend much more than five minutes filling out the form. This is not a detailed questionnaire; we are looking for your first reactions. Please respond with the first thing that comes into your mind. There are no right or wrong answers here, but you can get your questions answered and receive some support from our volunteers

Please complete the form - and we will be happy to connect with you. Questions can be directed to Gerald Pallor (Gerald@openHubproject.com) or Yulia Ovchinnikova (Yulia@openhubproject.com).

If you'd like to share this form - use this easy to remember URL https://bit.ly/DigiAssessment

Thank you!

Your name *

Your contact information (phone/email) - if you want us to contact you

What kind of device are you using?

Smartphone

Laptop / Desktop

Tablet

I don't have a device

Other:

Clear selection

Do you have Internet / WiFi at home?

Yes

Clear selection

What is your home Internet provider?

Spectrum

Verizon

Optimum

Viasat

Consolidated Communications

Ultra Home Internet

HughesNet

Frontier

Other

How frequently do you check your email?

Several times a day

Once a day

A couple times a week

Can't remember

I don't have an email address

Clear selection

How often do you use social media such as Facebook and Twitter?

Several times a day

Once a day

A couple times a week

Can't remember

I don't use social media

Option 6

Clear selection

I feel confident using the Internet

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet to find out about events in my community

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet to connect with family and friends

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet for entertainment (YouTube, video games)

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet to search for job opportunities

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet to schedule telehealth appointments

Strongly Disagree

Strongly Agree

Clear selection

I use the Internet to check my bank account

Strongly Disagree

Strongly Agree

Clear selection

I know how to keep my information safe and secure online

Yes

Clear selection

What else do you use the Internet for?

What would you need help with

Device Hardware (e.g. I need help turning on my smartphone)

Home Connectivity (e.g. I need help finding an Internet Service Provider)

Digital Skills (e.g. I need to get into my email)

Research (e.g. I need help finding information about my neighborhood)

I need digital skills to apply for a job

Other:

Clear selection

Would you like to learn more about any of the previously mentioned resources?

Yes

Clear selection

What is your digital literacy goal(s)?

Submit

Clear form

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