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What gender are you? 
 
Male
 
Female

 
 
 
Do you play any kind of sports? 
 
Yes
 
No

 
 
 
What sport do you play?
 
Soccer
 
Football
 
Basketball
 
Volleyball
 
Running sport
 
Cheerleading
 
Wrestling
 
Other

 
 
 
How many hours a week do you practice your sport if you play one?
 
2-4
 
4-6
 
6-8
 
9-more
 
I don't participate in sports

 
 
 
How do you feel when you are playing your sport? 
 
Anxious
 
Excited
 
Stressed
 
Unhappy
 
Open-minded

 
 
 
If you do not play a sport, how many outside activities do you participate in? 
 
1-2
 
2-3
 
3-4
 
5 and up

 
 
 
Do you ever feel uncomfortable with the image of your body? 
 
Never
 
Rarely
 
Sometimes
 
Often
 
Always

 
 
 
Do you ever feel like you're not doing your best because of the way your body looks?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Always

 
 
 
Do your coaches or teachers of your activity put pressure on you to the point where you feel self conscious in your own skin?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Always

 
 
 
If you do not play a sport, is a reason because of your body image?
 
Yes
 
No

 
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