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1. Demographics Section

Hi my name is Jennifer Klock and I am a graduate student at East Stroudsburg University of Pennsylvania. I would appreciate if you would partake in my survey which will look at the perception of a vegetarian/vegan and omnivore diet on health status. When clicking the DONE button at the end of the survey you are giving the consent to allow myself the researcher to use your data in my thesis. Thank you for taking the time to help with this. I look forward to the results.

1. Gender:

2. Age:

3. What is the highest level of education you have completed?:

4. What is your total household income?:

5. What is your current marital status?:

6. What is your ethnicity?:

7. Are you currently a?:

8. How long have you been a vegetarian, vegan, or omnivore?:

9. Do you use any form of tobacco more than three times a week?:

10. In the past month have you consumed more than five alcoholic drinks in one week?:

11. Do you exericse?:

12. If you exercise how many times a week do you exercise?:

13. What type of exercise?: Please fill in:

14. Which of the following food, if any do you NEVER eat? Please select all that apply. I never eat: