Sun Safe Colorado at School - Personal Risk Assessment

Personal Risk Assessment

What's your risk of skin damage?

1. When I go outside and it is sunny:

a.) I wear sunscreen:

AlwaysSometimesNever

b.) I wear a hat with a brim to protect myself from the sun:

AlwaysSometimesNever

c.) I wear sunglasses to protect my eyes from the sun:

AlwaysSometimesNever

d.) I stay in the shade to protect myself from the sun:

AlwaysSometimesNever

e.) I wear clothes covering most of my body (such as long pants, long sleeve shirts) to protect myself from the sun:

AlwaysSometimesNever

f.) I intentionally go out in the sun to get a tan:

AlwaysSometimesNever

2. Has anyone in your immediate family (parents, grandparents, brothers, or sisters) ever had skin cancer?

NoYes

3. What is the natural color of your hair?

Dark Brown-BlackLight-Medium BrownRed or Blond

4. What is the color of your untanned skin?

Dark BrownLight BrownMedium WhiteFair White

5. How many times in your life have you had a severe sunburn that blistered?

0-23-56-10More than 10

6. How many moles do you have that are bigger around than a pencil eraser?

NoneSomeA lot

7. How many freckles do you have?

NoneFewMany

8. When I go out into the summer sun for the first time:

I never burnI sometimes burnI always burn

9. My skin:

Tans easilyWill tan if I work at itDoes not tan

10. I live at this elevation:

0-4999 ft (1500 meters)5000 ft (1500 meters) or higher

11. Using the world map below, find the area you have lived for most of your life:

Area 1Area 2Area 3