The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

Untitled form
Send
Untitled form
Section 1 of 2
Email address
This form is collecting email addresses.Change settings
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Section 2 of 2
Question
Question Type
Loading image…
Female
Male
Add option
or
add "Other"
Answer key
(1 point)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Water
Regular Soda
Diet Soda
Tea
Coffee
Juices (Orange, apple, etc.)
Dairy Milk
Non-Dairy Milks (Almond, coconut, etc.)
Low Calorie Drink Mixes (Crystal Light, Mio, Etc.)
Sports Drinks (Gatorade, Powerade, etc.)
Alcohol
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Option 1
Add option
or
add "Other"
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Whole Grains (Rice, quinoa, etc.)
Bread (Sandwich slices, english muffins, bagels, wraps)
Sweet Potatoes
Other Potatoes (Russet, Yukon Gold, Etc.)
Oatmeal
Cold Cereal
Pasta
Cream of Wheat
Pretzels and Chips
Beans and Legumes (Black beans, chickpeas, etc.)
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Chicken
Turkey
Beef
Pork
Shellfish
Whole Fish (Salmon, tilapia, etc.)
Eggs and Egg Whites
Cottage Cheese
Greek Yogurt
Protein Powder
Protein Bars
Cheese
Milk
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Nuts and Seeds
Nut Butters
Olive Oil
Coconut Oil
Butter
Avocado and Guacamole
Sour Cream
Cream Cheese
Olives
Add option
or
add "Other"
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Leafy Greens (Spinach, Kale, Lettuce, Etc.)
Broccoli and Cauliflower
Carrots
Tomatoes
Squash and Zuchinni
Peppers
Onions
Green Beans
Mushrooms
Cabbage
Asparagus
Brussel Sprouts
Cucumbers
Celery
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
Question
Question Type
Loading image…
Apples
Bananas
Citrus Fruits (Oranges, grapefruit, etc.)
Berries (Blueberries, strawberries, etc.)
Melon (Watermelon, cantaloupe, honeydew, etc.)
Peaches
Pears
Grapes
Tropical Fruits (Pineapple, kiwi, etc.)
Other…
Add option