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Diet Survey 3.14.17

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Questions marked with a * are required Exit Survey
 
 
* What makes you frustrated or angry about being overweight? 
   
 
 
* What do you hate about diets?
   
 
 
* What do you feel is most important to you in a weight loss program? 
   
 
 
* What is the biggest pleasure you’ll achieve from reaching your goal weight?
   
 
 
* What is the thing or image that best represents support and accountability in your daily life? (For example, $ represents money, the sun represents summer).
   
 
 
Name (optional)
   
 
 
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