• During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, digging, aerobics, or fast bicycling? [MT3b]
• During the last 7 days, on how many days did you walk for at least 10 minutes at a time? [MT3a]

• Think about the last 7 days at work, at home, and in your spare time. How many hours did you spend sitting on a weekday? [MT3i]
  Responses: 0, 1, 2, 3, 4, 5, 6+ hours
• Think about the last 7 days. On how many days did you breathe a little harder than normal on one of those days? [MT3b]
  Responses: 0, 1, 2, 3, 4, 5, 6, 7 days

• During the last 7 days, how much time in total did you usually spend sitting on a week day? [MT3i]
  Responses: # hours, # minutes
• During the last 7 days, on how many days did you walk for at least 10 minutes at a time? This includes walking at work and at home, walking to travel from place to place, and any other walking that you did solely for recreation, sport, exercise or leisure. [MT3a]
  Responses: # days per week; hours and minutes
• During the last 7 days, on how many days did you do vigorous physical activities like jogging or running, fast bicycling, heavy shoveling or digging, or heavy lifting? Think about only those physical activities that you did for at least 10 minutes at a time. [MT3b]
  Responses: # days per week; hours and minutes
• Again, think only about those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do moderate physical activities like bicycling, active play with children, and light yard work or housework (for example, gardening, raking, washing windows, vacuuming, or carrying light loads)? Do not include walking. [MT3b]
  Responses: # days per week; hours and minutes

• In the past week, how many days did you exercise when you breathed harder than normal for at least 30 minutes? [MT3b]
• In the past week, how many days did you exercise to make your muscles stronger, such as lifting weights, working with elastic bands, doing push-ups, sit ups, etc.? [MT3c]
  Responses: 0, 1, 2, 3, 4, 5, 6, 7 days

• I do activities to increase muscle strength, such as lifting weights or calisthenics, once a week or more. [MT3c]
  Responses: yes, no

https://www.washburn.edu/student-life/recreation-wellness/employee-wellness/documents/EW-2011-President-Fitness.pdf NOTE: This assessment should only be given to people 18 years of age and older who are in good health. In addition, a pre-participation screening questionnaire should be administered prior to the administration of the fitness assessment. [MT3j]

• I do physical activities…
  Responses: never or almost never, most days, some days [MT3a]

• In the last 7 days, during your physical education (PE) or gym classes, how often were you active (playing hard, running, jumping, throwing)? [MT3d]
  Responses: hardly ever, sometimes, quite often, always, I don’t do PE or gym
• In the last 7 days, what did you normally do at lunch (besides eating lunch)? [MT3e]
  Responses: sat down (talking, reading, doing schoolwork), stood around or walked around, ran or played a little bit, ran around and played quite a bit, ran and played hard most of the time, this does not apply to me; I am only able to eat during lunch
• On an average school day, how many hours do you watch TV? [MT3g]
  Responses: I do not watch TV on an average school day, less than 1 hour per day, 1 hour per day, 2 hours per day, 3 hours per day, 4 hours per day, 5 or more hours per day

Condensed version of the School and Physical Activity Nutrition project (SPAN) – Chapter 1: Required Surveys for Impact Outcome Evaluation  https://www.cdph.ca.gov/programs/cpns/Pages/Chapter1RequiredSurveysforImpactOutcomeEvaluation.aspx

• During the week days, about how much time do you spend on a typical or usual school day sitting and watching TV, playing video games, or on a computer? Examples are: playing on a PSP or other handheld game, using an iPad or tablet, using the Internet (not for school), or watching movies or TV shows on a TV, computer, or phone. [MT3g,h,i]
  Responses: Less than 1 hour per day, 1 hour per day, 2 hours per day, 3 hours per day, 4 hours per day, 5 or more hours per day, I do not watch TV, play video games, or use a computer for something that is not for school work on school days
• Below, check all the days you exercised or took part in physical activity that made your heart beat fast and made you breathe hard for at least 60 minutes? Examples are: basketball, soccer, running or jogging, fast dancing, swimming, bicycling, jumping rope, trampoline, hockey, fast skating, or rollerblading. [MT3b]
  Responses: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday, I didn’t do any exercise last week that made my heart beat fast for 60 minutes

• During the past 7 days, how many days were you physically active for at least 1 hour? [MT3a]
  Responses: 0 days, 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days
• During the past 7 days, how often were you so active that your heart beat fast and you breathed hard most of the time? [MT3b]
  Responses: 2 times last week, 3 times last week, 4 times last week, 5 or more times last week
• How many hours a day do you spend watching TV or movies, playing electronic games, or using a computer for something that is not school work? [MT3g,h,i]
  Responses: never, 1 hour or less, 2 hours, 3 hours, 4 hours, 5 or more hours

• For each time period write in the number(s) of the main activities you actually did in the boxes on the time scale. [MT3a]
• Then rate how physically hard these activities were. Place an “X” on the rating scale to indicate if the activities for each time period were: [MT3b]
  Responses: Very Light = Slow breathing, little or no movement, Light = Normal breathing, regular movement, Medium = Increased breathing, moving quickly for short periods of time, Hard = Hard breathing, moving quickly for 20 minutes or more

1. On an average school day, how many hours do you watch TV? [MT3g]
   1. I do not watch TV on an average school day
   2. Less than 1 hour per day
   3. 1 hour per day
   4. 2 hours per day
   5. 3 hours per day
   6. 4 hours per day
   7. 5 or more hours per day
2. On an average school day, how many hours do you play video or computer games or use a computer for something that is not school work? (Count time spent on things such as Xbox, PlayStation, an iPod, an iPad or other tablet, a smartphone, YouTube, Facebook or other social networking tools, and the Internet.)[MT3h]
   1. I do not play video or computer games or use a computer for something that is not school work
   2. Less than 1 hour per day
   3. 1 hour per day
   4. 2 hours per day
   5. 3 hours per day
   6. 4 hours per day
   7. 5 or more hours per day

• How much time did your child spend playing in the yard or street around your house? [MT3a]
• How much time did your child spend playing at a park, playground, or outdoor recreation area? [MT3a]

Fitnessgram https://www.cooperinstitute.org/vault/2440/web/files/662.pdf 

This is the national health related fitness assessment for school-age children grades 4–12. [MT3j]