CKD Hot sauce

Thanks for coming - we're looking forward to learning your opinions

First please tell us a little about yourself.

Remember, all information is confidential.

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* 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)

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* 2. Are you male or female?

Male

Female

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* 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

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* 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

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* 5. Who is the primary cook in your household?

Significant other

Shared about 50:50

Care provider

Other

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* 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

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* 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

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* 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)

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* 1. which term best describes you (select the most suitable)

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* 2. Are you male or female?

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* 3. What is your age?

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* 4. When thinking of yourself or your primary patient's CKD, what best describes the stage

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* 5. Who is the primary cook in your household?

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* 6. How often do you cook your own meals?

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* 7. How confident or comfortable do you feel with the treatment program for CKD?

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* 8. Where do you typically find information on CKD diet? Please select the 2 sources that you most often use.

* 8. Where do you typically find information on CKD diet?
Please select the 2 sources that you most often use.