School District
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Academy 20 School District
Colorado Springs District 11
District 49
Harrison School District 2
Poudre School District
St. Vrain Valley School District
Steamboat Springs School District
Thompson School District
Weld School Districts
Widefield School District
Other
Academy 20 School District
Colorado Springs District 11
District 49
Harrison School District 2
Poudre School District
St. Vrain Valley School District
Steamboat Springs School District
Thompson School District
Weld School Districts
Widefield School District
Other
School
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Aspen Valley Middle School Challenger Middle School Discovery Canyon Campus Middle School Eagleview Middle School Journey Middle School Mountain Ridge Middle School Timberview Middle School Other
School
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Galileo School Of Math And Science Middle Holmes Middle Jack Swigert Aerospace Academy Middle Jenkins Middle Mann Middle North Middle Russell Middle Sabin Middle Tesla Educational Opportunity Middle West Middle Other
School
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Grand Mountain Middle Haven Middle Janitell Middle Sproul Middle Watson Middle Other
School
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Banning Lewis Preparatory Academy Middle Falcon MS Grand Peak Academy Middle Liberty Tree Academy Middle Mountain View Academy Middle Pioneer Technology & Arts Academy Middle Rocky Mountain Classical Academy Middle Skyview MS Springs Studio For Academic Excellence Middle Other
School
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North Routt Community Charter Middle Sleeping Giant Middle Steamboat Springs Middle Other
School
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Atlas Preparatory Middle School Fox Meadow Middle School James Irwin Middle School Mountain Vista Community School Panorama Middle School Sand Creek International School The Vanguard School Secondary Other Harrison
School
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Blevins Middle School Boltz Middle School Cache La Poudre Middle School Kinard Middle School Lesher Middle School Liberty Common Middle School Lincoln Middle School Polaris Middle School Preston Middle School PSD Global Academy Timnath Middle School Webber Middle School Wellington Middle School Other
School
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Alton Middle School Coal Ridge Middle School Erie Middle School Longs Peak Middle School Lyons Middle School Mead Middle School Soaring Heights Middle School Sunset Middle School Thunder Valley Middle School Timberline Middle School Trail Ridge Middle School Westview Other
School
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Bill Reed High Plains Middle School Lucile Erwin New Vision Middle School Peakview Academy Riverview Middle School Turner Walt Clark Other
School
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Brentwood Chappelow D6 Online Academy MS Eaton Middle School Franklin Heath Highland Middle School McAuliffe STEM Academy Milliken MS North Valley Platte Valley Prairie Heights Severance South Valley Tointon Academy of Pre-Engineering University Middle School Windsor Middle School Windsor Charter Middle School Other
School
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Dayspring Christian Academy MS Resurrection Christian MS Other
Please type your school
First Name
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Last Name
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Last Name Initial
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Today M-D-Y
Teacher's Last Name
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Class Period
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1. The heart and blood vessels are part of which body system?
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Digestive (Gastrointestinal)
Immune
Cardiovascular (Circulatory)
I don't know
Digestive (Gastrointestinal)
Immune
Cardiovascular (Circulatory)
I don't know
2. What are the names of the heart chambers?
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Atria and ventricles
Kidneys and arteries
Capillaries and veins
I don't know
Atria and ventricles
Kidneys and arteries
Capillaries and veins
I don't know
3. Your heart is made of _____________.
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Bone
Muscle
Tendon
I don't know
Bone
Muscle
Tendon
I don't know
4. HDL (the healthy cholesterol) removes _______________ from the blood.
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LDL (the lousy cholesterol)
Oxygen
Red blood cells
I don't know
LDL (the lousy cholesterol)
Oxygen
Red blood cells
I don't know
5. What are the two steps to save a life using Hands-Only CPR?
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Find the nurse and push hard and fast on the center of the stomach
Call 911 and do nothing else
Call 911 and push hard and fast in the center of the chest
I don't know
Find the nurse and push hard and fast on the center of the stomach
Call 911 and do nothing else
Call 911 and push hard and fast in the center of the chest
I don't know
6. How many grams of Added Sugars are in 1 pastry?
19 grams
24 grams
38 grams
I don't know
19 grams
24 grams
38 grams
I don't know
7. Eating healthy foods like fish, avocado, nuts/seeds, and olive oil can raise your HDL cholesterol.
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True
False
I don't know
8. Try to eat ___ servings of fruits and vegetables every day for a healthy heart and mind.
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2
3
5
I don't know
9. Secondhand vape can damage your cardiovascular system and blood vessels.
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True
False
I don't know
10. What is true about vaping?
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Decreases oxygen levels in the blood
Can raise your blood pressure
Is addictive
All of the above
I don't know
Decreases oxygen levels in the blood
Can raise your blood pressure
Is addictive
All of the above
I don't know
11. Try to exercise for ___ minutes every day for a healthy heart and mind.
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15 minutes
30 minutes
60 minutes
I don't know
15 minutes
30 minutes
60 minutes
I don't know
12. Managing stress can help lower your risk for heart disease.
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True
False
I don't know
Gender
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Male
Female
Prefer to self-describe gender identity
Prefer not to say
Male
Female
Prefer to self-describe gender identity
Prefer not to say
Gender
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Male
Female
Prefer not to say
Male
Female
Prefer not to say
Birthday
Month
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January February March April May June July August September October November December Prefer not to say
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Prefer not to say
2009 2010 2011 2012 2013 2014 Prefer not to say
1. On most days, how stressed or worried are you?
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Never
Low stress
Average stress
High stress
Very high stress
Prefer not to say
Never
Low stress
Average stress
High stress
Very high stress
Prefer not to say
2. On most days, how often do you look at food labels?
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Never
Hardly ever
Sometimes
Frequently
Always
Prefer not to say
Never
Hardly ever
Sometimes
Frequently
Always
Prefer not to say
3. On a normal school night, what time do you go to sleep?
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Earlier 8:00 pm 8:30 pm 9:00 pm 9:30 pm 10:00 pm 10:30 pm 11:00 pm 11:30 pm 12:00 am 12:30 am 1:00 am 1:30 am 2:00 am 2:30 am 3:00 am Later Prefer not to say
4. On a normal school day, what time do you wake up?
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Earlier 5:00 am 5:30 am 6:00 am 6:30 am 7:00 am 7:30 am 8:00 am 8:30 am 9:00 am Later Prefer not to say
5. Drink sugar-sweetened beverages?
(only count drinks with added sugar like soda, lemonade, iced tea, energy drinks or juice with added sugar)
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0 1 2 3 4 5 6 7 Prefer not to say
6. Eat 5 servings of fruits and vegetables combined ?
(1 serving is a 1/2 cup; it could easily fit in your hand)
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0 1 2 3 4 5 6 7 Prefer not to say
7. Exercise for a total of 60 minutes by the end of the day?
(either all at once or broken up)
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0 1 2 3 4 5 6 7 Prefer not to say
8. Get exposed to secondhand smoke or vape?
(near or next to someone who is smoking or vaping)
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0 1 2 3 4 5 6 7 Prefer not to say
9. Eat breakfast?
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0 1 2 3 4 5 6 7 Prefer not to say