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  5. Gluten Free Restaurant Survey
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How often do you go to restaurants?
 
Every Day
 
Once Every Week
 
Once Every Month
 
Never
 
 
 
Are you allergic to any certain types of foods?
 
Yes
 
No
 
 
 
How often do you eat healthy?
 
24/7
 
Mostly
 
Sometimes
 
Never
 
 
 
What is your Gender?
 
Male
 
Female
 
Other
 
 
 
What is your Age Range?
 
0-18
 
19-31
 
31-49
 
49-61
 
61 and over
 
 
 
Have you been to this restaurant before?
 
Yes
 
No
 
 
 
If you were to go to my restaurant, what foods would you enjoy?
 
Salad
 
Meats (Steaks, Chickens, etc.)
 
Soups
 
Sandwiches
 
Pizza

 
 
 
What is your date of birth?
 
 
 
Which state were you born in?
 
 
 
Thank you for taking my survey. As a final question, how often do you take surveys?
 
Daily
 
Weekly
 
Monthly
 
Never
 
Other
 
Other