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* 1. (N) Do you eat breakfast every day?

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* 2. (N) Do you eat fruits and vegetables every day?

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* 3. (N) Do you drink or eat 4 dairy servings a day? (Milk or Yogurt)

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* 4. (N) Do you drink soda?

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* 5. (E) Do you exercise every day?

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* 6. (E) Does your family exercise together?

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* 7. (E) Do you watch TV or play computer games?

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* 8. (E) Do you take medicine during the day at school?

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* 9. (S) Do you wear a bike helmet when you ride your bike or skateboard?

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* 10. (S) Do you wear a seatbelt when riding in a car?

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* 11. (S) Does anyone in your house smoke?

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* 12. (S) Students at my school treat each other with respect.

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* 13. (S) My property (coat, backpack, etc.) is safe at my school.

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* 14. (S) I feel safe at my school.

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* 15. (M) Do you have a best friend?

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* 16. (M) Do you feel happy most of the time?

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* 17. (M) Is someone home to greet you when you get home from school?

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* 18. (M) Do you go to daycare before or after school?

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* 19. (M) When you have a problem, can you talk to someone about it?

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* 20. (M) People at my school care about me as a person.

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* 21. (M) Does someone at home help you with homework at night?

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* 22. (A) I believe that I am able to do well in school.

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* 23. (A) Specials are an important part of my school day.

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* 24. (A) I believe that I contribute to making my school better.

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* 25. (D) Do you brush your teeth every day?

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* 26. (D) Have you ever been to the dentist?

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* 27. I am healthy.

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