This food habits questionnaire helps you understand how people shop for, prepare, and think about the food they eat. It is a short form built for community health projects, nutrition workshops, cooking classes, and student research. With 23 questions it prints on three pages.
What this survey measures
The template opens with everyday eating and cooking behavior. Respondents report how often they eat takeaway, how long they spend preparing a typical dinner, how often they cook from basic ingredients, and who cooks at home, then rate statements about cooking time, confidence, skills, and food waste. A diet and health section covers special diets, food allergies, and how healthy people feel their diet is. A food frequency grid shows how often people eat fruit, vegetables, whole grains, pulses, fish, meat, dairy, snacks, and sugary drinks, alongside portions of fruit and vegetables, breakfast, and water. A shopping section covers how often and where people buy food, weekly spend, skipped meals, and what matters when choosing food, followed by age, household size, and two comment boxes.
How to use it on paper
Print the questionnaire and hand it out at a class, clinic, market stall, or event, or leave stacks at a reception desk. Ask respondents to use a blue or black pen and mark one answer per question or row. Collect the completed forms in a folder or drop box. Scan or photograph them and upload to PaperSurvey, which reads the marked answers, the handwritten spend figure, and the comments automatically so you get clean, tallied results without manual data entry.
Customize this template
Most people swap in their own logo, adjust the age bands, and reword the frequency scales to match their audience. You can add questions about dietary needs or remove ones you do not need, and the layout reflows automatically to keep everything tidy.
Preview the PDF above, or use this template to start collecting responses today.