Diet Survey For MS Risk Assessment

How often do you eat outside your house (i.e. fast-food, restaurants) each week?

Everyday

1-3 times per week

4-6 times per week

I don't eat out

What do you eat when you eat outside your home (Select all that apply)?

When you eat outside of your house, where do you most often eat?

Fast-food (i.e. McDonald's, Taco Bell)

Food Truck

Casual Restaurant (i.e. Apple Bee's, Farmer Boys)

Fine Dining Restaurant

Friend/Relative

School/Work Cafeteria

I don't eat outside my home

How much time do you spend outdoors each day?

0-2hrs.

3-5hrs.

6+hrs.

Do you take a vitamin D supplements or a multi-vitamin supplement with vitamin D?

Yes

No

Do you take vitamin B12 supplements or take a multivitamin with B12 in it?

Yes

No