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	School District * must provide value 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 reset
	School * must provide value	Aspen Valley Middle SchoolChallenger Middle SchoolDiscovery Canyon Campus Middle SchoolEagleview Middle SchoolJourney Middle SchoolMountain Ridge Middle SchoolTimberview Middle SchoolOther
	School * must provide value	Galileo School Of Math And Science MiddleHolmes MiddleJack Swigert Aerospace Academy MiddleJenkins MiddleMann MiddleNorth MiddleRussell MiddleSabin MiddleTesla Educational Opportunity MiddleWest MiddleOther
	School * must provide value	Grand Mountain MiddleHaven MiddleJanitell MiddleSproul MiddleWatson MiddleOther
	School * must provide value	Banning Lewis Preparatory Academy MiddleFalcon MSGrand Peak Academy MiddleLiberty Tree Academy MiddleMountain View Academy MiddlePioneer Technology & Arts Academy MiddleRocky Mountain Classical Academy MiddleSkyview MSSprings Studio For Academic Excellence MiddleOther
	School * must provide value	North Routt Community Charter MiddleSleeping Giant MiddleSteamboat Springs MiddleOther
	School * must provide value	Atlas Preparatory Middle SchoolFox Meadow Middle SchoolJames Irwin Middle SchoolMountain Vista Community SchoolPanorama Middle SchoolSand Creek International SchoolThe Vanguard School SecondaryOther Harrison
	School * must provide value	Blevins Middle SchoolBoltz Middle SchoolCache La Poudre Middle SchoolKinard Middle SchoolLesher Middle SchoolLiberty Common Middle SchoolLincoln Middle SchoolPolaris Middle SchoolPreston Middle SchoolPSD Global AcademyTimnath Middle SchoolWebber Middle SchoolWellington Middle SchoolOther
	School * must provide value	Alton Middle SchoolCoal Ridge Middle SchoolErie Middle SchoolLongs Peak Middle SchoolLyons Middle SchoolMead Middle SchoolSoaring Heights Middle SchoolSunset Middle SchoolThunder Valley Middle SchoolTimberline Middle SchoolTrail Ridge Middle SchoolWestviewOther
	School * must provide value	Bill ReedHigh Plains Middle SchoolLucile ErwinNew Vision Middle SchoolPeakview AcademyRiverview Middle SchoolTurnerWalt ClarkOther
	School * must provide value	BrentwoodChappelowD6 Online Academy MSEaton Middle SchoolFranklinHeathHighland Middle SchoolMcAuliffe STEM AcademyMilliken MSNorth ValleyPlatte ValleyPrairie HeightsSeveranceSouth ValleyTointon Academy of Pre-EngineeringUniversity Middle SchoolWindsor Middle SchoolWindsor Charter Middle SchoolOther
	School * must provide value	Dayspring Christian Academy MSResurrection Christian MSOther
	Please type school name	Please type your school
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	Date	TodayM-D-Y
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Middle School Healthy Hearts and Minds Pre "What do you know?" If you don't know an answer to the question, just select 'I don't know.' We want to see how much you know, not how good you are at guessing.
	1. The heart and blood vessels are part of which body system? * must provide value Digestive (Gastrointestinal) Immune Cardiovascular (Circulatory) I don't know Digestive (Gastrointestinal) Immune Cardiovascular (Circulatory) I don't know reset
	2. What are the names of the heart chambers? * must provide value 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 reset
	3. Your heart is made of _____________. * must provide value Bone Muscle Tendon I don't know Bone Muscle Tendon I don't know reset
	4. HDL (the healthy cholesterol) removes _______________ from the blood. * must provide value LDL (the lousy cholesterol) Oxygen Red blood cells I don't know LDL (the lousy cholesterol) Oxygen Red blood cells I don't know reset
	5. What are the two steps to save a life using Hands-Only CPR? * must provide value 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 reset
	6. How many grams of Added Sugars are in 1 pastry?
	* must provide value 19 grams 24 grams 38 grams I don't know 19 grams 24 grams 38 grams I don't know reset
	7. Eating healthy foods like fish, avocado, nuts/seeds, and olive oil can raise your HDL cholesterol. * must provide value True False I don't know True False I don't know reset
	8. Try to eat ___ servings of fruits and vegetables every day for a healthy heart and mind. * must provide value 2 3 5 I don't know 2 3 5 I don't know reset
	9. Secondhand vape can damage your cardiovascular system and blood vessels. * must provide value True False I don't know True False I don't know reset
	10. What is true about vaping? * must provide value 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 reset
	11. Try to exercise for ___ minutes every day for a healthy heart and mind. * must provide value 15 minutes 30 minutes 60 minutes I don't know 15 minutes 30 minutes 60 minutes I don't know reset
	12. Managing stress can help lower your risk for heart disease. * must provide value True False I don't know True False I don't know reset
Healthy Hearts and Minds Middle School Program Pre
	Gender * must provide value Male Female Prefer to self-describe gender identity Prefer not to say Male Female Prefer to self-describe gender identity Prefer not to say reset
	Gender * must provide value Male Female Prefer not to say Male Female Prefer not to say reset
	Self-described gender:
	Birthday Month * must provide value JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPrefer not to say
	Day * must provide value 12345678910111213141516171819202122232425262728293031Prefer not to say
	Year * must provide value 200920102011201220132014Prefer not to say
	1. On most days, how stressed or worried are you? * must provide value 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 reset
	2. On most days, how often do you look at food labels? * must provide value Never Hardly ever Sometimes Frequently Always Prefer not to say Never Hardly ever Sometimes Frequently Always Prefer not to say reset
	3. On a normal school night, what time do you go to sleep? * must provide value Earlier8:00 pm8:30 pm9:00 pm9:30 pm10:00 pm10:30 pm11:00 pm11:30 pm12:00 am12:30 am1:00 am1:30 am2:00 am2:30 am3:00 amLaterPrefer not to say
	4. On a normal school day, what time do you wake up? * must provide value Earlier5:00 am5:30 am6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 amLaterPrefer not to say
For questions 5-9, during a normal week, how many DAYS do you do the following:
	5. Drink sugar-sweetened beverages? (only count drinks with added sugar like soda, lemonade, iced tea, energy drinks or juice with added sugar) * must provide value	01234567Prefer 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) * must provide value	01234567Prefer not to say
	7. Exercise for a total of 60 minutes by the end of the day? (either all at once or broken up) * must provide value	01234567Prefer not to say
	8. Get exposed to secondhand smoke or vape? (near or next to someone who is smoking or vaping) * must provide value	01234567Prefer not to say
	9. Eat breakfast? * must provide value	01234567Prefer not to say
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