Survey-Week Two

1. I was able to implement my short-term goal over the past week.

a. True
b. False
2. I feel like my diet is:
a. Really balanced and rich in whole foods
b. Somewhat balanced, but could use some improvement
c. Not balanced at all and completely lacking in whole foods
d. Primarily food from restaurants and fast food
3. Setting a short-term goal each week is:
a. Very helpful
b. Somewhat helpful
c. Not helpful at all
4. After the workshop last week I:
a. Was more mindful when I ate
b. Was more mindful a few times when I ate
c. Was more mindful for a day or two
d. Wasnt more mindful at all, but thought about how I felt
when I ate quickly without mindfulness
e. Didnt really think about being mindful at all
5. Did you do a food journal for the past week? Please answer yes
even if you did it for a few meals.
a. Yes
b. No
6. If yes, please select how you felt about the activity.
a. I felt like tracking my food and paying attention to how I
felt was really helpful
b. I felt that tracking my food and paying attention to how I
felt was somewhat helpful
c. I felt that tracking my food and paying attention to how I
felt was really stressful
d. I felt that tracking my food and paying attention to how I
felt might be helpful, but I forgot or didnt have time
7. One thing I enjoyed from the workshop last week was:
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