1. What is your gender?

Male

Female

2. Do you have cancer in your family?

A) Yes

B) No

C) Unknown

3. Are you overweight? (Be honest.)

A) Yes

B) No

C) Somewhat

4. Do you smoke cigarettes?

A) Yes

B) No

C) Occasionally

5. How many fruits do you eat in a day?

A) 1-3

B) 3-6

C) 6 or more.

D) None

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