Diet History Questionnaire Ii Pdf

Some questions may not apply and may be left unanswered.

Diet history questionnaire ii pdf. 0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 r867 99d omb no. Estimate if you are not sure. General instructions answer each question as best you can. Do not use a pencil or felt tip pen.

Use only a black ball point pen. Diet history questionnaire. Do not make stray marks on this form. Estimate if you are not sure.

Estimate if you are not sure. There are diets that mainly focus on losing weight others gaining weight while others do it to maintain a healthy lifestyle in order to live a long and healthy life. There are however four different versions available for use described below. If you.

Do you try special or fad diets. Health and nutrition history client information please take a moment to complete this form in ink. It can be used by researchers clinicians or teachers without permission. Please bring this questionnaire with you to your appointment.

Do not fold staple or tear the pages. Do you add salt to foods during cooking at the. Do you drink enough fluids so that yes no your urine is a pale yellow color. The following questionnaire is designed to increase your knowledge and awareness of your overall diet and to highlight potential areas of concern.

A guess is better than leaving a blank. Do not use a pencil or felt tip pen. The information you share will help the registered dietitian have a better understanding of your needs. A guess is use only a.

A guess is better than leaving a blank. Diet history questionnaire ii general instructions answer each question as best you can. Be certain to completely blacken in each of the answers. 15 diet questionnaire examples in pdf there are a lot of diets and there are also a lot of reasons behind those diets.

There are four different versions of dhq ii in both paper and electronic formats. Do not fold staple or tear the pages. Erase completely if you make any changes. Diet history questionnaire ii general instructions answer each question as best you can.

Project first diet history questionnaire. The dhq ii that queries intake for the past year and includes portion size is the standard version of the nci s diet history questionnaire for canada for which there are related validation data.