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Surveys
2014
May
B
Behavioral Outcomes
Behavioral Outcomes
How often do you visit the doctor?
Once a year or when sick
Once every 2 years
Only when sick
Once every 3 years or more
Never
How often do you exercise?
Everyday
4-6 days per week
1-3 days per week
Twice a month
Never
How often do you eat fast foods?
Every day
Every week
Every 2 - 3 weeks
Every month
Every 2 - 3 months
Every 4 - 6 months
Once or twice a year
How would you rate your level of satisfaction with your health?
Highly satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Highly dissatisfied
How much would you rate the taste of the following vegetables ?
Well Below Average
Below Average
Average
Above Average
Well Above Average
Broccoli
Corn
Green beans
Carrots
Zucchini
Tomatoes
Comment:
How likely are you to add more fruits to your diet?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
How likely is it that you have health concerns?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
Do you work or do you have children?
What is your gender?
Male
Female
Prefer not to answer
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