Diet Planning Questionnaire


Diet planning questionnaire is very essential to chalk out definite plans to make a diet chart for a healthy lifestyle. Priority is given to both physical fitness and psychological strength by formulating a balanced diet with a practical approach. An optimized combination of a variety of nutritious foods is the key to a good diet and healthy living.

Diet Planning Questionnaire Sample

Q1. Please cooperate to provide us with the data of your current weight, height and age.

_____________

Q2. Do you have diabetes?

  1. Yes
  2. No

Q3. How many hours do you devote to sleeping?

  1. Below 6
  2. 6 to 8
  3. More than 8

Q4. Please provide us with your normal pulse rate.

____________

Q5. Are you a vegetarian or a non-vegetarian?

____________

Q6. Do you visit gym?

  1. Yes
  2. No

Q7. If answer to Q6. Is option ‘a’, then what is the frequency of visit?

  1. Daily
  2. Once in three days
  3. Once in a week
  4. Irregular

Q8. Do you go for swimming?

  1. Yes
  2. No

Q9. If answer to Q8. is option ‘a’, then what is the frequency of going to the swimming pool?

  1. Daily
  2. Once in three days
  3. Once in a week
  4. Irregular

Q10. At work, how many hours do you spend outdoors?

  1. Zero
  2. Around 1 hour
  3. 1 to 3 hours
  4. More than 3 hours

Q11. Do you work in heavy industries?

  1. Yes
  2. No

Q12. Do you want specific diet to focus on losing your weight or keeping you in good shape?

  1. Losing my weight
  2. Keeping myself in good shape
  3. Both

Category: Planning Questionnaire

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