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| 1. On
a scale from 1 to 10 (with 10 being very important), how important is your
health?____ |
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| 2. Does
cancer, diabetes, obesity, stroke, hypertension, or heart disease run in your
family? |
Yes No |
| 3. Did
you know that improving your diet could possibly help to lower your health care
costs? |
Yes No |
4. Did
you know that a diet rich in fruits and vegetables has been proven to
strengthen your immune system, repair DNA, reduce oxidative stress, improve
circulation, and improve digestion and regularity?
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Yes No |
5. Can
you or your family get excited about the saving associated with fewer doctors'
visits and less missed time from work and school?
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Yes No |
| 6. Does
anyone in your household/family take vitamins? |
Yes No |
7. Are
you aware of the recent research that stares vitamins are largely ineffective
and may do more harm than good and your best source of vitamins, minerals, and
antioxidants are found in whole foods?
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Yes No |
8. Do
you have School age Children?
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Yes No |
9. Do
you know that children are more harmed by poor diet than by exposure to
alcohol, drugs, and tobacco combined?
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Yes No |
| 10. Are you aware this generation of children will
have a shorter life expectancy than their parents due to poor diet? |
Yes No |
| 11. Did you know that 70% of adult and childhood
diseases are preventable through good nutrition? |
Yes No |
| 12. Are you interested in finding additional ways to
add more fruits and vegetables to your diet? |
Yes No |
13. Would you be interested in hosting an
informative and fun wellness presentation in your home, office or place of
worship to share the gift of good health and family, friends, and neighbors?
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Yes No |
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