Do you own or have access to
a bicycle?
Yes
No
Do you use a helmet when you
ride?
Yes
No
Have you ever fallen off your
bicycle and hit your head?
Yes
No
a. If you answered yes: Were you wearing a helmet?
Yes
No
b. Did you tell an adult?
Yes
No
Have you ever been taught how
to fit a helmet properly?
Yes
No
How often do you wear your
helmet when you bicycle?
Always
Sometimes
Never
N/A