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* 1. Gender

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* 2. Age

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* 3. Which of the following conditions are you dealing with, if any? Check all that apply.

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* 4. Do you follow (or are trying to follow) any type of special diet now? Check all that apply. 

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* 5. How much do you enjoy/are you able to cook your own meals? (1 - "Where IS my kitchen?", 4 - "I live for making most of my meals from scratch."

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i We adjusted the number you entered based on the slider’s scale.

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* 6. Which type of nutrition guidance have you utilized, if any?  Check all that apply.

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* 7. What are your biggest sources of frustration when trying to eat healthfully/change your lifestyle?

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* 8. Based on the list below, rank the strategies you want to learn MOST about to improve your health? (1 - Most, 10 - Least)

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* 9. Ideally, how would you most prefer to learn about nutrition & health strategies? Choose one.

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* 10. Is there anything else you'd be willing to share about your health & nutrition goals/struggles/challenges so I can serve you even better? 

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