Your Lifestyle Questionnaire

1. Do you enjoy preparing and cooking meals?

2. List in order your most frequent cooking style?

	Grilling	Frying	Roasting	Steaming	Boiling	Microwave
1	1 Grilling	1 Frying	1 Roasting	1 Steaming	1 Boiling	1 Microwave
2	2 Grilling	2 Frying	2 Roasting	2 Steaming	2 Boiling	2 Microwave
3	3 Grilling	3 Frying	3 Roasting	3 Steaming	3 Boiling	3 Microwave
4	4 Grilling	4 Frying	4 Roasting	4 Steaming	4 Boiling	4 Microwave
5	5 Grilling	5 Frying	5 Roasting	5 Steaming	5 Boiling	5 Microwave
6	6 Grilling	6 Frying	6 Roasting	6 Steaming	6 Boiling	6 Microwave

3. How important is eliminating the following from your meals?

	Very	Fairly	Not important
Oils	Oils Very	Oils Fairly	Oils Not important
Fats	Fats Very	Fats Fairly	Fats Not important
Greases	Greases Very	Greases Fairly	Greases Not important
Salts	Salts Very	Salts Fairly	Salts Not important
Sugars	Sugars Very	Sugars Fairly	Sugars Not important
Processed Spices	Processed Spices Very	Processed Spices Fairly	Processed Spices Not important

4. 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?

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

6. Inasmuch as your health is important, it is inasmuch important as to how you source, how you prepare, how you cook and where you cook your food. Would you agree?

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

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

9. Would you be interested in learning how to cook for a CURE, eliminating the root causes of the above-mentioned diseases?

Would you prefer a Home Visit or attend our Cook School?

10. What time is best for you during the week?

10:30am
6:00pm
Which day? (please specify)

11. Please provide us with your contact details: *

First name	*
Last name	*
E-mail	*
Tel	*

If this sounds like something you want to know more about, please book online www.simbasfoods.com

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