Thanks for coming - we're looking forward to learning your opinions First please tell us a little about yourself. Remember, all information is confidential. Question Title * 1. which term best describes you (select the most suitable) CKD patient Medical Care provider for a CKD patient Home care provider (non-medical) for CKD patient Other (please specify) Question Title * 2. Are you male or female? Male Female Question Title * 3. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 + I'd prefer not to answer Question Title * 4. When thinking of yourself or your primary patient's CKD, what best describes the stage Stage 1 through 4 Stage 5 (dialysis) None of the above Question Title * 5. Who is the primary cook in your household? Me Significant other Shared about 50:50 Care provider Other Question Title * 6. How often do you cook your own meals? Never Less than 5 meals a week 5-10 meals a week More than 10 meals a week Question Title * 7. How confident or comfortable do you feel with the treatment program for CKD? Not at all Quite Good but could learn more Very N/A Dialysis Dialysis Not at all Dialysis Quite Dialysis Good but could learn more Dialysis Very Dialysis N/A Diet Diet Not at all Diet Quite Diet Good but could learn more Diet Very Diet N/A Medication Medication Not at all Medication Quite Medication Good but could learn more Medication Very Medication N/A Question Title * 8. Where do you typically find information on CKD diet? Please select the 2 sources that you most often use. Hospital expert or nutritionist Internet: general food or diet sources CKD specialist websites e.g. Kidney Foundation Other (please specify) Next