SCORECARD FOR EATING AND ACTIVITY	
Date:	    /      /                   	    /      /         	    /      /	    /      /	    /      /	    /      /	    /      /	
Breakfast 								
Snack								
Lunch								
Snack								
Dinner								
Snack								
30-min of moderate activity Y/N								
Eating score; Total H’s ____ x 2.86 equals a score of  ____%   
Circle activity score:
Activity score; 5Y’s = 100%; 4Y’s = 90%; 3Y’s = 80%; 2Y’s = 70%; 1Y = 60%; 0Y’s = 0	
Copyright © 1997 by  Healthy Changes.  4742 Liberty Rd. S. Box 303 Salem, Or. 97302-5000 
Reprinted with permission	
Name: ____________________________			Date: ________________

Due Lab 7