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Nutrition Survey
Hi! First, Thanks a lot for your participate! I am Vickie Liu from Bur Oak Secondary School. The course I am currently taking is Families in Canada (HHS4U). This survey is about nutrition, which relate to my culminating project. I want to receive some feedbacks and responses through this survey. In order to complete my culminating project, your input is very important. We will NOT share any your personal information without your consent. If you have any questions, you may contact my teacher Ms. Hatanaka at ainsley.hatanaka@yrdsb.ca *If you feel uncomfortable while doing the survey, you're welcome to skip the question or stop the survey at anytime.

Thank you.

Your Gender: Your Age:

1.I often neglect my diet. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

2. I have difficulty making decisions of food. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

3. I neglect exercise. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

4. I eat breakfast. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

5. I have specific plan what to eat. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

6. I look at the Nutrition Facts before I eat. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

7. I count how many calories I took before/after every meal. A. Never B. Sometimes C. Fairly Often D. Very Often E. Always

8. Are you interesting in nutrition? A. Yes B. No C. Somehow

9. Do you think food is relating to nutrition? A. Yes B. No

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