Your Lifestyle Questionnaire

 

1. Are you trying to eat healthier? *

 

2. Do you enjoy preparing and cooking meals? *

 

What do you eat the most in your household? *

 

3. How much do you spend on Vitamins / Supplements weekly? *

 

4. List in order your most frequent cooking style? *

GrillingFryingRoastingSteamingBoilingMicrowave
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5. How important is eliminating the following from your meals? *

VeryFairlyNot important
Oils
Fats
Greases
Salts
Sugars
Processed Spices with animal products
 

6. Would you agree that eating food prepared and cooked through the above methods can affect how you LOOK, how you FEEL and how long you LIVE? *

 

7. Please tick any of the following diet related health concerns in your family / household? *

 

8. Do you have anything in place to protect your health? *

 

9. Do you have Medical Aid? *

 

10. What would be your biggest health concern in the future? *

 

11. If you had a 90day health goal, what would it be? *

 

12. Will you be interested in knowing why DIETING is not working for most people and why DIET related diseases are on the increase by the day? *

 

13. How did you know about Simba's Foods? If you received a flyer please write the booking code at the bottom of the flyer. *

 

14. Please provide us with your contact details: *

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Check out our survey templates or create your own.