Food Frequency Questionary
Food Frequency Questionary
Frequency Questionnaire
Thank you for participating in this research study. An important part of this study is the
Food Frequency Questionnaire, designed to measure your dietary pattern over the past
year. Remember, the infonnation we get from the study is only as good as the
infonnation you give us. Accuracy is essential!
Please complete this form and bring it with you at the time of your appointment, or
complete prior to the time of your home visit.
1) Please use a No.2 pencil, and make sure the circles are completely darkened.
2) Please do not leave any questions blank. If the section does not apply to you, please
fill in the '~never" section.
3) Please do not separate, staple or rip the booklet.
4) Please do not leave any stray marks. Make sure all erasures are complete.
1.
Check that there are no staples, rips, tears, or writing other than where indicated.
If so, the form must be redone.
2.
3.
4.
Check that a response has 'been filled in for every line. Ifnever used, fill in that
circle.
5.
6.
For vitamins, make sure the brand, the dose and how long taken is written in the
spaces provided.
7.
Make sure that all extra foods are written in the numbered spaces (up to 4 items)
with complete information.
8.
Make sure that what is written in the extra foods section is not something that is
already in another part of the questionnaire.
9.
10.
Make sure to stamp the date on top when the participant brings in the form.
Thank you for participating in this research study. An important part of this study is the
Food Frequency Questionnaire, designed to measure your dietary pattern over the past
year. Remember, the information we get from the study is only as good as the
information you give us. Accuracy is essential!
Please complete this form and bring it with you at the time of your appointment, or
complete prior to the time of your home visit.
1) Please use a No.2 pencil, and make sure the circles are completely darkened.
2) Please do not leave any questions blank. If the section does not apply to you,
please fill in the "never" section.
4) Please do not leave any stray marks. Make sure all erasures are complete.