Families Eat Healthy Stay Healthy-Health Outcomes

Did this program meet your specific health goals?

Yes

No

NA

Please name the goals that were achieved from this program?

Please list

Did this nutrition education program increase your servings of fruits and vegetables?

Yes

No

Please state your past weight before this nutrition education program and your current weight?

Please list

What assessments has the nutritionist made regarding your current diet?

Please list

How many servings of fruits and vegetables do you and your family consume daily in your diets?

I always have fruits and vegetables in my home?

Yes

No

How many times per week do you and your family eat at fast food restaurants?

Do you feel you eat healthier after taking this nutrition education program?

Yes

No

Maybe

If you could change anything in your diet, what would you like to change?

Please list

Thank you for your participation in this survey.