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* 1. How old are you?

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* 2. Do you have children? If yes please specify how many and their ages in the comments box

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* 3. What are your 3 biggest stresses or struggles with your eating?

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* 4. What are your other challenges regarding food management?

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* 5. What are your main goals regarding your food management (select 3 please)

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* 6. Which of the following diets have you been on in the last 20 years?

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* 7. Where do you need most help regarding food management resources?

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* 8. What are your strengths regarding managing your food intake and being healthy?

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* 9. What are your weaknesses regarding managing your food intake and being healthy?

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* 10. If I could come up with a set of wish list resources to help you with eating better and managing your food better, what you they be?

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* 11. If you struggle with emotional eating, could you please describe and explain any know triggers (stress, boredom, hurt / upset, certain situations, other people etc.) and the sorts of things you eat / do

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* 12. If there is anything else that you’d like to write here about your food management struggles and how someone like me could help you, please write here

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* 13. If you’d like a personal response to this survey if you don’t mind me knowing you who are please write your details here

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