| 2b | I do some moderate physical activities, but not every week. Does this describe you? | Yes □ | No □ | Not Sure □ |
| 4a | I do some moderate physical activities every week, BUT less than 30 minutes per day. Does this describe you? | Yes □ | No □ | Not Sure □ |
| 4b | I do some moderate physical activities every week, BUT less than 5 days per week. Does this describe you? | Yes □ | No □ | Not Sure □ |
| 6 | I do 30 minutes or more per day of moderate physical activities, 5 or more days per week. Does this describe you? | Yes □ | No □ | Not Sure □ |