How are you?

I eat fruit and vegetables

• at least once a day

• a few times a week

• once a week

• rarely/never

I drink water

• On a regular basis throughout the day

• Only when I'm thirsty

• I drink soda

• Only when I have meals

I eat sugary snacks and junk food

• at least once a day

• a few times a week

• once a week

• rarely/never

Do you do physical activities for at least 30 minutes a day?

• Never

• Sometimes

• Only on weekends

• Yes

I eat fish

• rarely/ever

• once a week

• a few times a week

• at least once a day

Do you spend a lot of time sitting and watching TV or playing video games?

• Sometimes

• No

• Yes

• I don't know

Do you talk to someone when you feel sad or upset?

• Yes

• I talk to my pet instead

• No, I keep it to myself

• I prefer to write in a journal

Do you take deep breaths and count to 10 when you feel angry?

• No

• I hold my breath and count to 100

• Yes

• I scream and punch things

Do you help with chores at home, like cleaning your room or setting the table?

• Yes

• No

• Sometimes

• Only when asked