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1
. How physically healthy are you?
How physically healthy are you?
Extremely healthy
Very healthy
Moderately healthy
Slightly healthy
Not at all healthy
2
. What health goals do you have for yourself in 2012
What health goals do you have for yourself in 2012
Lose weight
Reverse a specific health condition
Exercise more
Other (please specify)
3
. Are you interested in improving your diet as a way to improve your health?
Are you interested in improving your diet as a way to improve your health?
Yes
No
Other (please specify)
4
. Did you know that eating a plant-based diet can prevent, treat and even reverse many chronic health conditions?
Did you know that eating a plant-based diet can prevent, treat and even reverse many chronic health conditions?
Yes
No
5
. What is your diet like?
What is your diet like?
Typical American Diet - meat, dairy, eggs, processed foods
Healthier American Diet - meat, dairy, eggs, few processed foods, more organic foods
Vegetarian Diet (lacto/ovo) - no meat, but eat dairy and/or eggs
Vegan Diet - no animal products
Other (please specify)
6
. Would you be interested in any of the following services as a way to improve your diet?
Would you be interested in any of the following services as a way to improve your diet?
One on One Counseling
Private or Group Cooking Classes
Personal Chef Services
Free Teleclasses
Free in-person Lectures
Group Programs
Other (please specify)
7
. What food(s) would you be interested in learning more about?
What food(s) would you be interested in learning more about?
Tofu
Tempeh (fermented soy)
Seitan (wheat gluten)
Whole Grains
Leafy Greens
Sea Vegetables
Healthy Desserts
Other (please specify)
8
. Would you be interested in a 6 week group program to teach you how to use the above-mentioned foods?
Would you be interested in a 6 week group program to teach you how to use the above-mentioned foods?
Yes
No
9
. If you were to attend a group program what time would work best for you?
If you were to attend a group program what time would work best for you?
Weekdays
Weeknights
Saturday mornings
Other (please specify)
10
. What teleclass or lecture topics would you be most interested in?
What teleclass or lecture topics would you be most interested in?
The Top Health Benefits of a Plant-Based Diet
How to Maintain Healthy Bones Naturally
Weight Loss Made Easy
How to Prevent and Reverse Diabetes
Eating for a Healthy Heart
Other (please specify)
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