Healthier by Design E-Form for September 2017

This e-form is to be completed for the month of September.

September 2017

E-form to be completed between September 29-October 3.
The drawings will take place on Wednesday, October 4.

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* 1. What is your last name?

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* 2. What is your first name?

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* 3. What is your work email?

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* 4. Where do you work?

Home Office

Midwest Office

Southeast Office

Gulf Coast Office

Southwest Office

Lake Mary Office

Birmingham Office

Mid-Atlantic Office

Field/ Home

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* 5. I attest the following is true (fill in circle next to statement):

Each week, I ate the "featured" food item. This means, I ate/ drank the featured item at the Eastside Café, I ate/drank the featured items at home, and/or I ordered something at a restaurant that featured the weekly item.

Week 1: Prebiotics
Week 2: Probiotics
Week 3: Lentils
Week 4: Onion and/or Cold Potatoes

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* 6. Did you take the time to make at least one of the recipes posted on www.fcciwellness.com during the month of August? If you mark 'Yes', your name will be entered twice for the drawing (increasing your odds of winning)! NEW! Please write in the comment box which recipe you prepared on your own.

Yes, I made at least one of the Healthier by Design recipes from the website

No, I did not

Which recipe?

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* 7. Quiz question: Check off the one that does NOT apply. Lentil facts:

A) The French green Puy lentil and the black lentil have the highest antioxidant content.

B) Lentils are high in fiber.

C) Lentils do not require soaking overnight.

D) Lentil seeds have been found to be used as far back as 10,000 years ago.

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* 8. True or False: Onions are a source of chromium which is beneficial for blood sugar control.

True

False

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* 1. What is your last name?

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* 2. What is your first name?

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* 3. What is your work email?

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* 4. Where do you work?

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* 5. I attest the following is true (fill in circle next to statement):

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* 6. Did you take the time to make at least one of the recipes posted on www.fcciwellness.com during the month of August? If you mark 'Yes', your name will be entered twice for the drawing (increasing your odds of winning)! NEW! Please write in the comment box which recipe you prepared on your own.

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* 7. Quiz question: Check off the one that does NOT apply. Lentil facts:

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* 8. True or False: Onions are a source of chromium which is beneficial for blood sugar control.

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* 9. Please share any comments about September's Challenge, Be Good to Your Gut, or the Healthier by Design Challenge in general.