How Do You Feel About Your Body?

What is your date of birth?

Month	Year

On a scale of 1-5, 1 being "Not at all", 5 being "Extremely":

How confident are you in your appearance?

Do you like your body?

Do you think others like your body?

Do you care what others think of your body?

In 1-4 sentences, sum up how you feel about your body:

What is your favorite thing about your body/ your appearance?:

What is your least favorite thing about your body/ appearance?:

What is the meanest thing anyone has ever said about your body?:

What is the nicest thing anyone has ever said about your body?: