Digital Detox Assessment Form for Wellness Retreats Template

A pre-arrival questionnaire for wellness retreats that maps each guest's phone habits, screen triggers, and detox goals so your team can plan a fitting unplugged stay.

Use Template
Used 1 times
4.9
Created by Fomr Team
Last updated

About

Guests arrive at a digital detox retreat with very different relationships to their phones. Some check messages before they are fully awake, while others already keep devices out of the bedroom and want a deeper reset. This assessment gives your team a clear picture of each guest before arrival, so you can plan a stay that challenges them without overwhelming them.

The form starts with name, email, and age range, then moves through daily screen time, morning routines, notification volume, the apps that pull guests in most, and how social media affects their mood. Later questions cover sleep habits, boundaries between work and personal device use, physical symptoms such as eye strain or disrupted sleep, and how much disconnection each guest feels ready for. It closes with the offline activities they enjoy, the support they want, and their preferred retreat length.

Most questions are quick multiple choice or select-all lists, so guests can finish in a few minutes. If someone says they have tried a digital detox before, a follow-up asks how that experience went, which helps you spot guests who may need extra structure. Guests without that history never see the extra question.

Retreat coordinators, wellness coaches, and hospitality teams can use the answers to group guests by readiness, choose workshops, and set expectations about device storage before check-in.

Related Templates

View all →
Employee Coaching Form preview

Employee Coaching Form

Use this employee coaching form to document key takeaways from 1:1 coaching sessions, including goals, action steps, obstacles, confidence level, and the next meeting date. It gives managers, HR teams, and coaches a clear, repeatable way t…

Catering Request Form Milk & Honey preview

Catering Request Form Milk & Honey

Use this consent form online to collect the details you need before starting a conversation, project, or request. It helps teams qualify submissions and respond with better context.

What's Your Cocktail Personality? preview

What's Your Cocktail Personality?

This what's your cocktail personality? form helps bars, beverage brands, and event marketers run a playful quiz that matches people to a cocktail style while capturing names and email addresses for follow-up. It is a strong fit for social…

Class Registration Form preview

Class Registration Form

Use this event registration form to track responses, attendee details, and follow-up information in a single workflow. It gives organizers a simple way to manage registrations without extra admin work.

Clinical Trial Site Selection Inquiry preview

Clinical Trial Site Selection Inquiry

A clinical trial site selection inquiry form helps sponsors, CROs, and research teams gather the study details needed to identify and evaluate suitable trial sites. This template captures core protocol and patient population information in…

Branding Project Intake Form preview

Branding Project Intake Form

Empower your branding projects from the start with this essential intake form template. It guides creative professionals in capturing crucial client details like project goals, target audience, style preferences, and necessary assets for a perfectly aligned kickoff.

Hotel Damage and Incident Report Form preview

Hotel Damage and Incident Report Form

A hotel damage and incident report form helps staff document room damage, guest complaints, and safety issues in a consistent way. This template captures the details managers need to assess urgency, track costs, and follow up properly.

Chronic Pain Coaching Intake Form preview

Chronic Pain Coaching Intake Form

A chronic pain coaching intake form helps health coaches gather key background details before the first session, including pain history, symptom patterns, daily impact, and client goals. This template gives you a clear starting point for c…

Frequently asked questions

Who is this digital detox assessment designed for?

It is built for wellness retreats, mindfulness centers, and coaches who run unplugged programs. Guests fill it out before arrival so staff know how attached they are to their devices and what kind of break they are ready to take.

Does the form give guests a personality type or score?

No. The form collects habits and preferences, and your team reviews the answers to shape the stay. If you want to send each guest a written profile, the email question at the start gives you a way to follow up.

Why does the form ask where guests keep their phone at night?

Sleep is one of the areas where device habits show up most clearly. Knowing whether a phone stays on the nightstand or in another room helps you decide how to handle device storage and evening wind-down sessions during the retreat.

What happens when a guest says they have done a digital detox before?

A follow-up question appears asking how that previous attempt went. Guests who answer no skip it entirely. The answer helps you identify people who struggled last time and may benefit from a buddy, coaching, or a more structured daily schedule.

Can I change the retreat lengths and activities to match my program?

Yes. The retreat duration options and the list of offline activities are meant to be edited. Replace them with the workshops, treatments, and package lengths you actually offer so guests choose from real options.

When should guests receive this assessment?

Send it after booking and at least a week before arrival. That gives your team time to review answers, plan group activities, and contact anyone who chose a complete disconnect about what to expect.

Your next form could be the best-looking thing on your site.

Free forever. Unlimited responses. No signup to start.