Healthy Foods Survey - A Red Circle
ID *not required
Your answer
What neighborhood do you live in?
Your answer
What is your zipcode?
Your answer
Where do you mainly go grocery shopping?
Does your store have a wide selection of produce?
What is the quality of your store’s produce selection?
If there was a store with access to affordable, healthy options, would you shop there?
Do you think its possible for healthy food to taste good?
Do you cook daily?
How often do you eat fast food?
How often do you eat at restaurants (not fast food)?
If restaurants offered more healthy choices, would you choose them?
Do you think your schedule affects when and where you choose to eat?
What mode of transportation do you use to get to the store?
How far do you have to travel to get the food you want?
What food do you wish was more available to you? (check all that apply)
If answered "Other" above, please specify
Your answer
Are you available to canvas the neighborhood with A Red Circle or talk to members in the neighborhood?
Do you have cooking supplies (pots, pan, working stove, etc.)?
Do you have or live with kids?
Does their school provide lunch?
If yes, what do they offer?
Your answer
Is someone at home with the kids after school?
How do the kids eat during the summer?
If other, please specify
Your answer
How do the kids eat on the weekend?
If other, please specify
Your answer
Who’s in charge of buying the groceries?
Which is closer to your home—a convenience store or grocery store?
What is your income level?
What is your age?
What is your race?
How many people live in your house?
Do you use food stamps (EBT)?
Have you heard of or been to a farmers’ market?
If your neighborhood had a local farmers’ market, would you shop there?
How many earners are in your household?
Does your family have any health concerns (diabetes, high blood pressure, stroke, etc.)?
Your answer
What is your level of education?
Do you receive disability?
What would you change about North County if you could?
Your answer
How concerned are you about the upcoming Shop and Save closures?
Submit
Never submit passwords through Google Forms.
This form was created inside of SLU. Report Abuse - Terms of Service