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  2. 2014
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  5. EDHS 2000 Survey
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Exit Survey
 
 
What is your name?
   
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
What is your height in inches? (EX: 5'8 = 58)
   
 
 
 
What is your weight in pounds?
 
90-105 lbs.
 
106-120 lbs.
 
121-134 lbs.
 
135-150 lbs.
 
151-164 lbs.
 
165-180 lbs.
 
181-196 lbs.
 
197-212 lbs.
 
213-227 lbs.
 
228-242 lbs.
 
242-250 lbs.
 
250+ lbs.
 
 
 
I tend to devalue myself.
 
1
 
2
 
3
 
4
 
5
 
 
 
I am highly effective at the things I do
 
1
 
2
 
3
 
4
 
5
 
 
 
I am very comfortable with myself
 
1
 
2
 
3
 
4
 
5
 
 
 
I am almost always able to accomplish what I try for
 
1
 
2
 
3
 
4
 
5
 
 
 
I am secure in my sense of self-worth
 
1
 
2
 
3
 
4
 
5
 
 
 
It is sometimes unpleasant for me to think about myself
 
1
 
2
 
3
 
4
 
5