Child Wellbeing Health Awareness Survey Form
Please complete this survey to help us understand and promote child wellbeing and health awareness. Your responses are anonymous and valued.
How would you rate the overall wellbeing of your child?
*
1
2
3
4
5
How often does your child engage in physical activity (e.g., play, sports, exercise)?
*
Every day
Several times a week
Once a week
Rarely
How would you describe your child's eating habits?
*
Very healthy
Mostly healthy
Somewhat healthy
Needs improvement
How aware is your child of healthy lifestyle choices (nutrition, exercise, sleep, etc.)?
*
Not aware
1
2
3
4
Very aware
5
1 is Not aware, 5 is Very aware
Which of the following healthy habits does your child practice regularly? (Select all that apply)
Eating fruits and vegetables
Getting enough sleep
Drinking water
Physical activity
Limiting screen time
Other
How often does your child talk about their feelings or emotions?
Very often
Sometimes
Rarely
Never
How confident are you in supporting your child's wellbeing and healthy habits?
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Which resources or information would you find most helpful for promoting your child's wellbeing?
Nutrition guides
Exercise ideas
Mental health tips
Sleep routines
Other
What challenges do you face in supporting your child's wellbeing?
Any additional comments or suggestions?
Submit Survey
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