Nutrition and Wellness

What about You Survey?
Name: 


A red asterisk (*) indicates required questions.

  1. I make food choices based on the nutrients in food.*
    Yes
    No


  1. I typically eat breakfast.*
    Yes
    No


  1. I try to exercise 30 or more minutes each day.*
    Yes
    No


  1. I usually drink six or more glasses of water each day. *
    Yes
    No


  1. I eat out/away from home at least two nights a week.*
    Yes
    No


  1. My favorite food to eat at home is   *


  1. List the groups in the Food Pyramid. (Hint, there are six)*


  1. During a school week, I will eat ____ meals together with my family.   *


  1. My idea of a perfect meal would include . . . .


  1. I can identify the six classes of nutrients in food. *
    Yes
    No


  1. At home, I cook . . .*
    not at all
    a few things
    at least once a week
    many things throughout the week


  1. I can take care of and store food properly.
    Yes
    No


  1. One dietary guideline that I know is . . ..


  1. Natural orange juice with no additives is a good supply of . . . .*
    Vitamin A
    Vitamin C
    Calcium
    Iron
    Protein


  1. I go grocery shopping . . .*
    never
    only if I have to
    about once a week
    I do most of the shopping for my family


  1. My family will usually spend _____ for groceries during a month.
    $80
    $150
    $250
    $350
    $450 or more
    I have no idea how much they spend.


  1. You can always make food without using convenience items such as mixes more cheaply than using a mix. *
    Yes
    No


  1. The kitchen appliance that I use the most is . .. .*
    stove
    refrigerator/freezer
    microwave
    mixer
    Where is the kitchen?


  1. My family's food/meal choices are based primarily on . . .
    cost
    food likes and dislikes
    health
    time available to prepare & eat
    ethnic factors


  1. Food prepared without using mixes or boxes is always healthier for you. *
    Yes
    No


  1. I would rate myself as a _____ cook.*
    Beginning
    Good
    Developing
    Master


  1. The most difficult food that I have ever tried to make is . . . .


  1. One thing that I hope to learn from this class is . . .





Mrs. Debra Kraft
CTE instructor-Hospitality & Tourism
Mobridge Pollock High School
Mobridge, SD