DishWithDina: Client Feedback

An asterisk (*) indicates a required answer. All other fields may be left blank if necessary.

This is an anonymous survey. Please include your name/e-mail address at end of survey or e-mail dishwithdina@gmail.com if you would like to be quoted on the DishWithDina.com website (only your initials and city/state will be used).

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* 1. In which DishWithDina program(s) did you participate? (choose all that apply)

Long-term Individual Healthful Lifestyle Coaching/Nutrition Counseling (e.g., 6 months)

Short-term Individual Healthful Lifestyle Coaching/Nutrition Counseling (30 minutes, 1 hour, or free consultation)

Meal & Menu Planning Stand-alone Session

Kitchen and Pantry Assessment Stand-alone Session

Cooking Skills Instruction (individual or multiple sessions)

Personal Chef

Grocery Store Tour

Greenmarket Tour

Brunch Bunch

Monthly Group Healthful Lifestyle Webinar/Teleconference (includes Facebook groups)

Corporate Wellness Lunch and Learn

Recipe Revamp

Other (please specify)

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* 2. Prior to your DishWithDina program, you completed a New Client Questionnaire in which you were asked to state your goals. Did your DishWithDina program help you complete your goals or provide you with the proper steps/tools in order to begin completing them?

Yes

N/A (I did not complete a questionnaire/state my goals prior to my program.)

If no, please elaborate:

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* 3. What did you like most about the DishWithDina program(s) in which you participated?

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* 4. Was there anything about the DishWithDina program(s) you believe could be improved?

Yes

If "yes," please clarify:

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* 5. If you received a free consultation or program, how much would you be willing to pay for this program? (enter as a whole number, i.e., $125)

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* 6. If you paid for a particular DishWithDina program, how do you believe this was priced in comparison to similar programs? (skip this question if you did not pay for a program)

Less expensive

Priced about the same

More expensive

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* 7. How likely are you to consider purchasing--or purchasing another--DishWithDina program in the near future (3 months to a year from now)?

Extremely likely

Very likely

Moderately likely

Slightly likely

Not at all likely

If "not at all likely," please clarify:

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* 8. How likely are you to recommend a DishWithDina program to someone you know? (visit http://dishwithdina.com/services/ ifyou'd like to review complete list of programs)

Extremely likely

Very likely

Moderately likely

Slightly likely

Not at all likely

If "not at all likely," what are your recommendations or suggestions on improving this program?

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* 9. The DishWithDina monthly newsletter is still in the works. If you would like to suggest any food- or nutrition-related topics to be included in the newsletters, please indicate below.

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* 10. If you have any additional feedback, please enter below. Please include your name/e-mail address at this time or e-mail dishwithdina@gmail.com if you would like to be quoted on the DishWithDina.com website (only your initials and city/state will be used).