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Hello: I am a senior at UC Berkeley conducting a survey for my sociology class. The questionaire actually consists of two separate surveys, consolidated into one form for your convenience. The first part is a series of questions about your diet. The second part is regarding your personal assessment about yourself. If you feel that neither of the choices are applicable to you, please just choose one you lean more towards.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. Your honest answers are very important to my research and will be greatly appreciated.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact me, Elena Chung, by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
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DIETARY SURVEY:
I consciously choose what I eat on a daily basis. |
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I eat whatever is the most convenient. |
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When choosing what to eat, the most important factor to consider is: |
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My religion and/or my personal beliefs keep me from eating certain types of food. |
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| If yes, please list those foods you do not eat. | | |
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There are certain foods I refuse to eat because I just don't like them. |
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| If yes, please list those foods you do not eat here. | | |
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I am allergic to some foods. |
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| If yes, please list those foods you are allergic to here. | | |
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I tend to eat this many meals a day: |
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If I could choose whatever I wanted to eat, I would choose some kind of meat dish. |
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| What types of meat do you usually eat? (beef, chicken, lamb, etc.) | | |
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SELF ASSESSMENT: I tend to: |
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If I must disappoint someone, I usually am: |
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I consider myself to be a: |
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When dealing with confrontation: |
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When I am mad or frustrated, I tend to: |
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I tend to make decisions rather: |
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