IBS Roadmap Survey
Thank you for helping me better understand your needs around IBS and Nutrition! More info about my unique online group program can be found at
Do you have a medical diagnosis of irritable bowel syndrome (IBS)?
What are your main digestive symptoms? (Check all that apply)
What are your biggest challenges when it comes to your digestion? (The more specific and detailed you are, the more likely I'll be able to help!)
What is your experience with the FODMAP Diet? If you haven't done the full 3-phase elimination diet yet, what worries or obstacles have gotten in your way?
Which topics are you most interested in learning about? (Check all that apply)
Which resources would be most helpful for you to have while following the FODMAP Diet? (Check all that apply)
Low-FODMAP cooking hacks (e.g., garlic-infused oil, ingredient substitutions)
Meal prep ideas
Quick and easy meals
What to feed my family when I'm on the FODMAP diet
Sample meal plans
Dining out tips
Following the FODMAP diet during Covid (grocery shopping, ingredient availability, food safety)
What is your gender?
Prefer not to say
Tell me about your family/household:
I have a child/children living with me
I have adult children
I am not a parent
If you are interested in my group program: Please describe your current work schedule and responsibilities (e.g., part-time or full-time caregiving and/or work: full-time/part-time, at home, or outside of the home)
If you are interested in my group program: Which of the following days/times would you be able to attend live online group meetings/trainings? (Check all that apply)
Tuesdays 9-10am PST
Tuesdays 10-11am PST
Tuesdays 11am-12n PST
Tuesdays 12-1pm PST
Tuesdays 1-2pm PST
Tuesdays 2-3pm PST
Tuesdays 3-4pm PST
Tuesdays 4-5pm PST
Tuesdays 5-6pm PST
Wednesdays 12:30-1:30pm PST
Fridays 9-10am PST
Please enter your email address if you would like to be added to my mailing list. (If you complete this survey by 10pm PST October 16, 2020, I will also enter you into a drawing to win a $15 Amazon gift card!)
Lastly, I may follow up with a few people personally to learn more about your situation. If you'd be open to chatting for a few minutes, on the condition that I promise not to sell or promote anything, please enter your full name and email address below. Thank you!!
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service