Nominate a Restaurant/Cafe for a FoodSense Dietitian Menu Review

Question Title

* 1. How important are healthy choices on the menu to you?

Extremely important

Very important

Somewhat important

Not so important

Not at all important

Question Title

* 2. What is the name and address of the restaurant/cafe that you want to nominate for a FoodSense Dietitian Menu Review to include healthy choices?

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* 3. How often do you eat at this restaurant/cafe?

Every day

A few times a week

About once a week

A few times a month

Once a month

Less than once a month

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* 4. What would having FoodSense Dietitian Stamp of Approval healthy choices on the menu at this restaurant/cafe mean to you? Please select all that apply.

I can be healthier

I will be more confident about my food choices

I will recommend my family/friends to eat here

I will eat at this restaurant/cafe more often

I will order more takeaway from this restaurant/cafe

I will feel more secure when eating out

I will trust this restaurant/cafe on what they are serving me

I will be informed about the nutritional value of healthy choices

I will be more satisfied with my customer experience

Other (please specify)

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* 5. What is your gender?

Female

Male

Prefer Not to Answer

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* 6. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

Question Title

* 7. What is your first name?
(Your responses to this survey may be used to emphasise the importance of healthy choices on menus. You may choose to remain anonymous.)

Nominate a Restaurant/Cafe for a FoodSense Dietitian Menu Review

Question Title

* 1. How important are healthy choices on the menu to you?

Question Title

* 2. What is the name and address of the restaurant/cafe that you want to nominate for a FoodSense Dietitian Menu Review to include healthy choices?

Question Title

* 3. How often do you eat at this restaurant/cafe?

Question Title

* 4. What would having FoodSense Dietitian Stamp of Approval healthy choices on the menu at this restaurant/cafe mean to you? Please select all that apply.

Question Title

* 5. What is your gender?

Question Title

* 6. What is your age?

Question Title

* 7. What is your first name? (Your responses to this survey may be used to emphasise the importance of healthy choices on menus. You may choose to remain anonymous.)

* 7. What is your first name?
(Your responses to this survey may be used to emphasise the importance of healthy choices on menus. You may choose to remain anonymous.)