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Heart Smart - Child Outcome Survey

1. How many HeartSmart lessons have you had?

None	One or two	Quite a few	Loads!
None	One or two	Quite a few	Loads!

2. Did you do HeartSmart last year too?

Yes	No	I don't know	Not sure - but I've done HeartSmart before
Yes	No	I don't know	Not sure - but I've done HeartSmart before

3. How old are you?

6	7	8	9	10	11	12
6	7	8	9	10	11	12

4. What school do you go to? (type in your answer and then press enter to continue)

The second part of this survey will ask you to rate 15 statements.
For each statement please indicate how you feel.

Lets go!
Lets go!

The second part of this survey will ask you to rate 10 statements.
For each statement please indicate how you feel.

Lets go!
Lets go!