Yoga and Food Survey
When buying food what are you most concerned about?
Check any that apply:
Where do you get information regarding your nutrition
Check any that apply:
How satisfied are you with your eating habits?
not at all
deeply satisfied
Where do you buy groceries?
Do you grown any of your own food?
If yes, how much?
0-10%
50% or more
Generally how much of what you eat is grown or made locally?
0 - 10%
90% or more
Of the food you buy, how much is certified organic?
0 - 20 %
80 - 100%
How often do you consume:
never
a little
daily
every chance I get
not in the last week
not in the last month
not in the last year
coffee
tea
chocolate
alcohol
tobacco
Do you consider yourself
on special occasions
ideally
when I can
daily
never
I practice this!
I promote this!
vegan
vegatarian
pescatarian
omnivore
carnivore
What percentage of the food that you eat is raw?
0 - 10 %
100%
Do you follow ayurvedic nutritional practices?
What dosha are you?
Choose 
Pitta
Pitta Kapha
Kapha
Kapha Vata
Vata
Vata Pitta
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