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What days do you work out during the week?
0 1-2 3-4 5-6 7
 
 

Who do you work out with, if anyone?
 
Alone
 
Friend
 
Husband/Wife
 
Co-Worker
 
Other
 

 
 

Where do you work out?
 
At home
 
Local gym
 
At school
 
YMCA
 
Other
 

 
 

Do you use protein supplements or meal replacements now?
 
Meal replacements
 
Supplements

 
 

Why do you work out?
 
Fitness
 
Health
 
Strength training
 
Other
 

 
 

What brands of nutritional supplements have you used in the past?
 
Power Bar
 
Balance
 
Odwalla
 
Clif
 
Other
 

 
 

Do you buy products online?
 
Yes
 
No
 
If no,why?
 
 
 

What influences your purchasing decisions regarding nutritional supplements?
 
Price
 
Taste
 
Convience of purchase
 
Ingredients
 
Other
 

 
 

Do you eat breakfast, lunch and dinner?
 
Yes
 
No
 
If no, which meals do you skip and why?
 
 
 

What does your workout routine consist of?
 
I do not have a workout routine.
 
Fill in routine here
 
 

Are you currently dieting?
 
Yes
 
No
 
If so, which diet are you using and why?
 
 

Where does your daily protein come from?
 
Meat
 
Fish
 
Dairy
 
Eggs
 
Vegetables
 
Other
 

 
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