Personalized Nutrition Education (PNE) Study: Participant Questionnaire 1

PNE Study

Thank you for participating in this study. This questionnaire is being sent to you prior to your next visit with our research staff. If you have questions about the survey you can email the research associate at ashwini.rajasekaran@kpu.ca.

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* 1. Please enter your participant ID. This number would have been emailed to you.

As part of this study, we would like to know more about you. Please complete the following.

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* 2. Gender at birth

Male

Female

Prefer not to respond

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* 3. Date of Birth (dd/mm/yyyy)

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* 4. Current relationship status (note: Common-law refers to living with another person as a couple but not legally married to that person)

Single

Married or Common-law

Divorced, separated

Widowed

Never married

Other (please specify)

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* 5. What is the highest level of education you have completed.

High school not completed

High school graduate

Some postsecondary but not completed

Postsecondary trade certificate or diploma

University degree

Other (please specify)

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* 6. What is your household income (before taxes) for 2018?

Less than $18,000

$18,000 to $35,000

$35,001 to $45,000

$45,001 to $90,000

More than $90,000