Body Image Survey

Question Title

* 1. What is your gender?

Female

Male

Question Title

* 2. What is your Age?

<18

18 - 29

30 - 44

45 - 59

60+

Question Title

* 3. How would you rate your body image confidence/comfort?

Extremely uncomfortable with my body image

2

3

4

5

6

7

8

9

I love my body and have no body image issues

Extremely uncomfortable with my body image

2

3

4

5

6

7

8

9

I love my body and have no body image issues

Question Title

* 4. How would you categorize your level of fitness?

Very out of shape

2

3

4

Average

6

7

8

9

Very in shape

Very out of shape

2

3

4

Average

6

7

8

9

Very in shape

Question Title

* 5. How attractive is your body to your peers?

Extremely unattractive

2

3

4

Average

6

7

8

9

Extremely attractive

Extremely unattractive

2

3

4

Average

6

7

8

9

Extremely attractive

Question Title

* 6. What is your most attractive body part?

Shoulders/traps

Ass/butt

Breasts/Pecs

Hips/Lovehandles

Arms

Stomach

Thighs

Legs

Feet

Question Title

* 7. Please provide a way for us to contact you to get written approval to use your body photo. (photos will not be personally identified, and you should not submit photos with your face/head.)