1. During the school year, I consume ___ servings of fruits and vegetables per day.

  • 0
  • 1 to 2
  • 3 to 4
  • 5
  • More than 5

2. During the school year, I am physically active ___ days a week

  • 0
  • 1 to 2
  • 3 to 4
  • 5 to 6
  • 7

3. During the school year, my overall level of stress is ___.

  • Low
  • Below Average
  • Average
  • Above Average
  • High

4. During the school year, I have felt overwhelming anxiety

  • Yes,
    at least once a week
  • Yes,
    at least once a month
  • Yes,
    within the academic year
  • No,
    not within the academic year
  • No, never

5. During the school year, I have felt so depressed it was difficult to function

  • Yes,
    at least once a week
  • Yes,
    at least once a month
  • Yes,
    within the academic year
  • No,
    not within the academic year
  • No, never

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