Obesity:	□yes	□no
Diet/physical activity:	□yes	□no
Asthma:	□yes	□no
Diabetes:	□yes	□no
Smoking/SHS:	□yes	□no
Environmental/occupational health:	□yes	□no
Mental health:	□yes	□no
Health communication/literacy:	□yes	□no
Hypertension:	□yes	□no
Built environment:	□yes	□no
Disabilities:	□yes	□no
Cancer:	□yes	□no
Cardiovascular disease:	□yes	□no
□Other _________________________
□Refused