Eating Habits Questionnaire

Please answer the questions as honestly as you can. There are no right or wrong answers.

General eating patterns


As best as you can remember right now, tell me generally about an average day of eating and drinking.
This doesn’t have to be perfect; just capture your usual patterns.

Food and health

Hunger cues and appetite

Daily habits and environment

Your goals and priorities

You will receive a copy of your filled-out worksheet through your email.