Have you ever got frustrated with everyone staring at their screens in your home?

Maybe it doesn't feel that bad, but you're here to see if taking a break could help your family team.

Answer the series of questions here and find out if a 30 day black out might be right for your home.

First Name

Email *

Phone *

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How often do family members use devices (phones, tablets, computers) during meals? *

Always

Often

Sometimes/Rarely

Never

When having family time, how often are devices a distraction or cause interruptions? *

Constantly

Frequently

Occasionally

Hardly ever

Do family members often prefer screen time (gaming, social media, etc.) over spending time together? *

Yes, all the time

Frequently

Sometimes

Rarely

How often do you feel like you need to remind family members to "unplug" or put down their devices? *

Several times a day

Daily

Occasionally

Hardly ever

Do family members tend to use technology as a way to avoid conflict or uncomfortable conversations? *

Yes, often

Sometimes

Rarely

Never

How often do family members express feeling frustrated or upset after using technology (e.g., social media, games)? *

Frequently

Occasionally

Rarely

Never

Have you noticed a decrease in meaningful communication between family members since technology use has increased? *

Yes, a lot

Yes, somewhat

Not much

Not at all

Do family members often multitask with technology during conversations or family activities? *

All the time

Often

Sometimes

Rarely/Never

How often do you or your family members feel anxious or irritable when devices are not available (e.g., no Wi-Fi, dead battery)? *

Very Often

Often

Sometimes

Rarely/Never

How frequently do you or your family schedule “tech-free” times or activities (e.g., game nights, outdoor activities)? *

Never

Rarely

Occasionally

Often

You answered all the questions! Now click submit to get your results!