Eating Habits Questionnaire Template

Get complete information about your patients eating habits by implementing this template. Zonka Feedback allows you to quickly and easily create a health questionnaire, in which you get information on the diet, eating habits, and more. Click on the ‘Use this template’ to begin with it.

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Understanding Eating Habits Questionnaire Template

Regulating an eating habits survey of your patient is important. The survey template is designed to gather detailed information about the patients' eating habits or diet routines. The survey can be conducted to gather patients' information even with no internet connection. The questionnaire asks patients about their regular eating habits, how many meals they take, and in what quantity. Do their dietary habits add any value to their health?

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Ready to Take it a Step Further?

With Zonka Feedback you can easily create the template without any fuss. There are ample questions you can add to the template which range from button choice, dropdown, image question and more. After creating your survey, you can share it with your patients via web app, SMS, embed link or kiosk mode.

You can also download and share email templates in your marketing & email platforms to get instant feedback and conduct amazing surveys. So, what are you waiting for? Use the template to get started with your feedback journey.

2 Questions

2Screens

30 secs to complete

List of Eating Habits Questions

The following questions are included in Eating Habits Questionnaire Template:

Can we have your name, please?
Please enter the following information of the patient
Please specify the types of vegetables consumed by the patient.
Please specify the frequency of fruit intake in a day?
Do you take 3-4 ltr of water per day?
Is there anything you'd like to add?

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FAQs about Eating Habits Questionnaire

1. What can I measure by using this template?

By using this eating habits questionnaire template one can measure the eating habits of your patients, whether they are eating healthy or not, their frequency of fruit intake, water intake, and more.

2. Where can I use this Eating Habits Questionnaire?

You can use a QR code at your touchpoint. Another method is to send an email or SMS survey to the customer once the service is completed. If you don't have access to the internet, you can conduct offline surveys using kiosks, mobile devices, or tablets.

Create and send this Eating Habits Questionnaire Template