Healthy Living Your Way Survey
Well, hey there, friend! I'm super excited that you're taking some time out to answer these questions. Your responses will help me to create a system for busy momma's who want healthy living to be simple!

RULES:
1. Answer all questions truthfully and with your heart - it's a really great way for you to discover what important to YOU!

How many adults currently live in your home? (18 years old +) *
How many tweens & teens currently living in your home? (10 - 17 years old, in school) *
How many children currently living in your home in school ( 4 - 9 years old) *
How many 'wee ones' currently living in your home not in school? (1 year - 4 years old) *
Who does the grocery shopping in your home? *
Where do you do most of your grocery shopping locally? (select as many as needed) *
Required
What is your families average monthly food budget?
Your answer
Any household/family dietary restrictions? This includes life-threatening allergies and food-sensitivities. If so, list below. If none, just type no or NA *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms