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What is your gender?
 
Female
 
Male
 
 
 
Which race/ ethnicity best describes you? (Please choose only one)
 
American Indian or Alaskan Native
 
Asian / Pacific Islander
 
Black or African American
 
Hispanic American
 
White / Caucasian
 
Other
 
 
 
 
What is your age?
 
15-17
 
18-20
 
21-23
 
24-26
 
27-29
 
30-32
 
33 and older
 
 
 
How physically healthy are you?
 
Extremely healthy
 
very healthy
 
Moderately healthy
 
Slightly healthy
 
Not at all healthy
 
 
 
How important is exercise to you?
 
Extremely important
 
Very important
 
Moderately important
 
Slightly important
 
Not at all important
 
 
 
What do you do most often for exercise?
 
Lift weights
 
Walk
 
Run
 
Hike
 
Swim
 
Dance
 
Aerobics
 
Pilates
 
Play a team sport
 
Other
 
 
 
 
How well do you manage your emotions?
 
Not well at all
 
Mildly well
 
Fairly well
 
Quite well
 
Extremely well
 
 
 
In general, how would you rate your overall mental or emotional health?
 
Excellent
 
Very good
 
Good
 
Fair
 
Poor
 
 
 
In general, how would you rate your overall health?
 
Excellent
 
Very good
 
Good
 
Fair
 
Poor
 
 
 
Are you currently in school?
 
Yes
 
No
 
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