2019-20 Student Wellness Survey
Please answer the questions below to help us develop programming for our school.
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What is your name? *
What grade are you in? *
How many fruits do you eat a day? *
How many vegetables do you eat a day? *
Approximately how many minutes of physical activity (activity that increases your heart rate, incorporates some heavy breathing and sweating) do you participate in daily? *
Where do you get your physical activity (examples-dance, sports, running, going to the gym, etc)? *
Which drinks do you drink most often? *
What is the recommended amount of water you should you drink each day? *
How many times a week do you eat fast food? (examples: McDonalds, Dunkin Donuts, Burger King, etc) *
What is your favorite healthy snack? *
What healthy food would you like to see in our school breakfast or lunch? *
How many hours on a weekend day do you spend on a screen (Phones, iPads, TV, Video Games, Computer) *
How many hours after a school day do you spend on a screen? *
What time do you go to bed? *
What physical activity would you like to see included into the school? *
What physical activity would you like to see offered before or after school? *
What causes stress? *
How do you handle or control stress? *
Please write 1 or more healthy goal(s) you have for yourself. *
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