Please enter the information below:
How old is your child today?
What is your child's gender?
Each week, how many days does your child eat breakfast?
Each week, how many times does your child eat fast food?
Each week, how many times does your family eat at the table together?
Each week, does your child drink more than one regular soda, sweet tea, fruit punch, or "sports drink"?
Most days, how many glasses of milk, cups of yogurt, or servings of cheese does your child eat or drink?
What kind of milk does your child drink?
Most days, does your child eat at least 5 servings of fruits and vegetables?
Most days, how much active play or sports does your child get, not counting time in school?
Most days, how much time does your child spend watching TV, playing video games, text messaging, and using the computer?
Most weeks, how many times does your family do something active together, such as hiking, walking, biking, or gardening?
Does your child watch TV or use a computer in his/her bedroom?
Most nights, what time does your child go to bed?
Most mornings, what time does your child wake up?