5 minutes to complete
To complete the Diet Plan Questionnaire, you must be at least 18 years old, have no underlying medical conditions that would restrict your ability to follow a diet plan, and be willing to commit to making lifestyle changes. Additionally, you should have access to a computer or smartphone to complete the questionnaire online.
Name
Age
Do you have any food allergies or intolerances?
Are you currently following any specific diet?
What is the diet plan you are following?
Do you have any medical conditions that affect your diet?
Are you currently taking any vitamins or supplements?
How many meals do you typically eat in a day?
What types of foods do you usually consume for breakfast?
How often do you eat out or order takeout?
How many servings of fruits and vegetables do you consume daily?
How often do you consume the following foods? Fried Foods
How often do you consume the following foods? Processed Snacks
How often do you consume the following foods? Sugary Beverages
On a scale of 1 to 5, how would you rate your current diet?
How often do you exercise?
What are your primary health goals?
What foods do you enjoy and would like to include more of in your diet?
Are there any foods you dislike and want to avoid in your plan?
Do you have any specific dietary preferences?
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