Holiwell survey

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Moving Towards a Plant Based Diet

please fill this out prior to class. no need to print it.

* Indicates required field

Name *

First

Last

Email *

How did you hear about this class? *

Facebook Event Patient at Holiwell Health Friend Rhona's social media

What is your age? *

19-25 26-35 36-50 Over 50 Prefer not to say

What are you hoping to learn most from this class? *

What does "plant based" mean to you? *

Vegan: completely free of all animal sourced foods Vegetarian: no meat, seafood or eggs, but some dairy is ok Pescetarian: so no meat, eggs or dairy, but some seafood is ok. Most of the diet is from plant foods, but allows room for meat, dairy, eggs or seafood

Feel free to elaborate on your view of the plant based diet. *

What, if any, health issues are you experiencing right now? *

If you are experiencing health issues, what are your thoughts on the benefits of a plant based diet? *

What other types of diets have you tried with the goal of having better health? *

Is weight loss or gain a goal of this experience? *

Do you enjoy cooking? *

Yes, and I cook for myself often Yes, but I rarely have time to cook for myself No, I don't enjoy it at all. No, but I am interested in learning to like it

What are your biggest challenges around cooking for yourself? *

What else would you like me to know so that I can create a more impactful experience with this class? *

Submit

I would love to connect with you....