CCT Lifestyle Survey Question Title * 1. What is your first and last name? (Must complete in order to receive credit for HSA contribution) OK Question Title * 2. What is your email address? OK Question Title * 3. How often do you participate in at least 30 minutes of moderate exercise? Less than once per week 1-3 times per week 4-7 times per week Other (please specify) OK Question Title * 4. How many servings of fruits and vegetables do you eat each day?Example of 1 serving: 1 cup leafy greens or 1 medium piece of fruit. Less than one serving 1-3 servings 4-6 servings More than 6 servings Other (please specify) OK Question Title * 5. Which of the following beverages do you drink regularly? (check all that apply) Water Milk Juice Coffee/Tea Soda/Pop Sport's drink Other (please specify) OK Question Title * 6. How often, on average, do you consume any of the following foods? pastries such as cakes, croissants, turnovers cookies rich desserts premium ice cream donuts high fat muffins 0-1 times per week 2-3 times per week 4-6 times per week 7 or more times per week Other (please specify) OK Question Title * 7. How often, on average, do you consume any high fat snack foods (e.g., potato chips, nachos, any fried chips, chocolate bars, etc.?) 0-1 times per week 2-3 times per week 4-6 times per week More than 7 times per week Other (please specify) OK Question Title * 8. Do you drink at least 64 ounces of water each day? Yes No Other (please specify) OK Question Title * 9. Do you think you get adequate sleep each night? Yes No Other (please specify) OK Question Title * 10. On average, how many hours of sleep do you get each night? 8 hours or more 6-7 hours 4-5 hours Less than 4 hours Other (please specify) OK Question Title * 11. Have you used Tobacco products in the last 12 months? Yes No OK NEXT