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Section 1 of 3
Food System Survey [TEMPLATE]
The purpose of this survey is to identify collective staple items in the house and to make sure we are using our shared money in the best way possible to give all housemates the food that they need for specific dietary requirements. It is also an opportunity to give feedback about the food system, report what you like and don't like, and to pitch some new ideas to improve, streamline, and build a system that works the best for all of us.
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Section 2 of 3
Staple Foods
I understand that a STAPLE is a food that I cannot live without and will use that sparingly to give a clear indication of what the house collectively NEEDS vs WANTS. This does not mean that food marked as non staples wont be purchased.
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I UNDERSTAND
I DO NOT UNDERSTAND
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What Dairy/Dairy Alternative Items do you need to survive?
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MUST HAVE
REALLY WANT BUT DONT NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Butter
Earth Balance Butter Alternative
Cheddar Chees
Parmesan Cheese
Mozzarella Cheese
Almond Milk
Cow Milk
Half & Half
Whole Milk Plain Yogurt
Canned Coconut Milk (For cooking)
Daiya
Row 12
Rows
1.
Butter
2.
Earth Balance Butter Alternative
3.
Cheddar Chees
4.
Parmesan Cheese
5.
Mozzarella Cheese
6.
Almond Milk
7.
Cow Milk
8.
Half & Half
9.
Whole Milk Plain Yogurt
10.
Canned Coconut Milk (For cooking)
11.
Daiya
12.
Row 12
13.
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MUST HAVE
REALLY WANT BUT DONT NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Protein Items do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Chicken
Beef
Pork
Fish
Eggs
Tofu
Veggie Patties
Tempeh
Lentils
Black Beans
Other beans
Rows
1.
Chicken
2.
Beef
3.
Pork
4.
Fish
5.
Eggs
6.
Tofu
7.
Veggie Patties
8.
Tempeh
9.
Lentils
10.
Black Beans
11.
Other beans
12.
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Bread Items do you need to survive?
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MUST HAVE
REALLY WANT BUT DONT NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Sprouted Multi Grain Sliced Bread
Bagels
Local bread loaf
Gluten Free Bread
Flour Tortillas
Corn Tortillas
Rows
1.
Sprouted Multi Grain Sliced Bread
2.
Bagels
3.
Local bread loaf
4.
Gluten Free Bread
5.
Flour Tortillas
6.
Corn Tortillas
7.
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MUST HAVE
REALLY WANT BUT DONT NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Condiments do you need to survive? Note that not all condiments like vinegars, oils and spices are not listed here as we are already calling them staples.
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Honey
Maple Syrup
Jam (Strawberry or Raspberry)
Hummus
Mayo
Salsa
Tahini
Dijon Mustard
Siracha
Rows
1.
Honey
2.
Maple Syrup
3.
Jam (Strawberry or Raspberry)
4.
Hummus
5.
Mayo
6.
Salsa
7.
Tahini
8.
Dijon Mustard
9.
Siracha
10.
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Grains do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DONT EAT
Rice Noodles
Pasta
White Rice
Brown Rice
Quinoa
Oats
Granola
Rows
1.
Rice Noodles
2.
Pasta
3.
White Rice
4.
Brown Rice
5.
Quinoa
6.
Oats
7.
Granola
8.
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DONT EAT
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What Snacks do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Trail Mix
Raisins
Walnuts
Shredded Coconut
Corn Chips
Popcorn
Dried Mango Slices
Frozen Berries
Dates
Sunflower Seeds
Hemp Seeds
Chocolate Chips
Almonds
Rows
1.
Trail Mix
2.
Raisins
3.
Walnuts
4.
Shredded Coconut
5.
Corn Chips
6.
Popcorn
7.
Dried Mango Slices
8.
Frozen Berries
9.
Dates
10.
Sunflower Seeds
11.
Hemp Seeds
12.
Chocolate Chips
13.
Almonds
14.
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Columns
MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Veggie Produce do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Avocados
Kale
Spinach
Chard
Brocolli
Cauliflower
Zucchini
Mushrooms
Eggplant
Tomatoes
Peppers
Squash
Hebs (Cilantro, Parsley, Dill)
Onions
Garlic
Ginger
Carrots
Cabbage
Rows
1.
Avocados
2.
Kale
3.
Spinach
4.
Chard
5.
Brocolli
6.
Cauliflower
7.
Zucchini
8.
Mushrooms
9.
Eggplant
10.
Tomatoes
11.
Peppers
12.
Squash
13.
Hebs (Cilantro, Parsley, Dill)
14.
Onions
15.
Garlic
16.
Ginger
17.
Carrots
18.
Cabbage
19.
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Fruit do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Kiwi
Bananas
Orange
Lemon
Mandarins
Apples
Canteloupe
Grapefruit
Berries
Rows
1.
Kiwi
2.
Bananas
3.
Orange
4.
Lemon
5.
Mandarins
6.
Apples
7.
Canteloupe
8.
Grapefruit
9.
Berries
10.
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Columns
MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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What Hot Beverages do you need to survive?
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MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
Coffee
Black Tea
Green Tea
Herbal Tea
Mate
Rows
1.
Coffee
2.
Black Tea
3.
Green Tea
4.
Herbal Tea
5.
Mate
6.
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Columns
MUST HAVE
REALLY WANT BUT DON'T NEED
WOULD EAT BUT DON'T CARE
DON'T EAT
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If you marked any of the above hot beverages as a must have, please describe the specific type and brand you would like. eg. The Tea Spot, Chai
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If there are STAPLE items that you require that are not listed above please let us know here.
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Answer key
(0 points)
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If there are items you would LIKE that are not listed above please let us know here.
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(0 points)
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If you have any dietary restrictions or allergies, please list them here.
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Do you have any extra comments about staple foods in general?
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Section 3 of 3
Food System Values and Purchasing
What makes a great food system in your opinion?  
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What values do you have (e.g. only buy organic)? What do you care about most when it comes to buying food? (e.g. flavor, environmental impact, farmworker wages, quality, pesticide use, low cost, etc.)
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Answer key
(0 points)
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How do you want things to function (e.g. distributed responsibility for farmer's market runs, regularity of shared meals)?
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(0 points)
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What do you think could be improved about the current food system?
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Skip this question if you do not already have a food system in place.
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If someone requests something that is not on our collective shopping list (e.g. hazelnut milk, matcha, candied pecans, etc.) how do you think we should decide whether or not to buy it?
Question Type
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Don't buy it
Buy it if we have extra money after staples
Buy it if it is requested
Buy it if it is for a communal recipe
Other…
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Would you be interested in buying into a meat or fish club every month outside of the food budget? For what amount?
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Are you okay with using Costco as a supplier for local, organic items comparable to what we buy at the farmers market and Berkeley Bowl?
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Berkeley Bowl - 50 to 100% more expensive, but supports local business
Costco - Cheapest option
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How would you feel about buying from Imperfect Produce--a company that salvages cosmetically imperfect produce from markets and stores and restaurants—to supplement foods from the farmer's market?  (yes, some of the produce will be ugly) take a look: http://www.imperfectproduce.com/#ugly-produce-delivered
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Yes
No
Maybe, I'd like to try it once or twice
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Any final thoughts or dreams?
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Name
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No responses yet for this question.
Staple Foods
I understand that a STAPLE is a food that I cannot live without and will use that sparingly to give a clear indication of what the house collectively NEEDS vs WANTS. This does not mean that food marked as non staples wont be purchased.
Copy chart
No responses yet for this question.
What Dairy/Dairy Alternative Items do you need to survive?
Copy chart
No responses yet for this question.
What Protein Items do you need to survive?
Copy chart
No responses yet for this question.
What Bread Items do you need to survive?
Copy chart
No responses yet for this question.
What Condiments do you need to survive? Note that not all condiments like vinegars, oils and spices are not listed here as we are already calling them staples.
Copy chart
No responses yet for this question.
What Grains do you need to survive?
Copy chart
No responses yet for this question.
What Snacks do you need to survive?
Copy chart
No responses yet for this question.
What Veggie Produce do you need to survive?
Copy chart
No responses yet for this question.
What Fruit do you need to survive?
Copy chart
No responses yet for this question.
What Hot Beverages do you need to survive?
Copy chart
No responses yet for this question.
If you marked any of the above hot beverages as a must have, please describe the specific type and brand you would like. eg. The Tea Spot, Chai
Copy chart
No responses yet for this question.
If there are STAPLE items that you require that are not listed above please let us know here.
Copy chart
No responses yet for this question.
If there are items you would LIKE that are not listed above please let us know here.
Copy chart
No responses yet for this question.
If you have any dietary restrictions or allergies, please list them here.
No responses yet for this question.
Do you have any extra comments about staple foods in general?
No responses yet for this question.
Food System Values and Purchasing
What makes a great food system in your opinion?  
No responses yet for this question.
What values do you have (e.g. only buy organic)? What do you care about most when it comes to buying food? (e.g. flavor, environmental impact, farmworker wages, quality, pesticide use, low cost, etc.)
No responses yet for this question.
How do you want things to function (e.g. distributed responsibility for farmer's market runs, regularity of shared meals)?
Copy chart
No responses yet for this question.
What do you think could be improved about the current food system?
No responses yet for this question.
If someone requests something that is not on our collective shopping list (e.g. hazelnut milk, matcha, candied pecans, etc.) how do you think we should decide whether or not to buy it?
Copy chart
No responses yet for this question.
Would you be interested in buying into a meat or fish club every month outside of the food budget? For what amount?
Copy chart
No responses yet for this question.
Are you okay with using Costco as a supplier for local, organic items comparable to what we buy at the farmers market and Berkeley Bowl?
Copy chart
No responses yet for this question.
How would you feel about buying from Imperfect Produce--a company that salvages cosmetically imperfect produce from markets and stores and restaurants—to supplement foods from the farmer's market?  (yes, some of the produce will be ugly) take a look: http://www.imperfectproduce.com/#ugly-produce-delivered
Copy chart
No responses yet for this question.
Any final thoughts or dreams?
No responses yet for this question.
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