Heal Dietitian Questionnaire
Feedback
We have added a Dietitian service within the clinic and would be grateful if you could complete this short questionnaire.
Many thanks in advance.
1.
Would you be interested in some input from a dietitian within the clinic?
Yes
No
2.
If yes, what type of advice / input would you like to see offered?
Nutritional Support
Low fodmap (for IBS)
Cholesterol Lowering advice
Blood pressure and diet
Food and Mood
Dietary information for heart health
Advice regarding Diabetes type 1 and type 2
Healthy eating advice
Diet during pregnancy
Diet and the menopause
Diet and falls
Other
Not applicable
3.
Would you prefer to see the dietician
Face to face
Via telephone
Online via Zoom / Microsoft teams
*
4.
Please provide your name and email address below and we will send you further information about the Dietitian once this is available
(Required.)