Health...What's that?

Is your health important to you?

Yes

No

Do you consider yourself in charge of your health?

Yes

No

If healthy food is available to you will you choose to eat it?

Yes

No

What would you like to see improve with your health?

More energy

Weight Gain

Decrease in illness

What diseases do you suffer from the most?

Malnutrition

Hypothermia

Nutrient Deficiency (anemia, scurvy)

Do you use alcohol?

Yes

No

Do you use illegal substances?

Yes

No

Do you use tobacco products?

Yes

No

Have you ever chosen alcohol, illegal substances, or tobacco products of food?

Yes

No

How many times per day do you have a nutritious meal?

1

2

3

4