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Get UConn Nutrition Initial Assessment Intake Form

Yes No o If yes which meals, please check all that apply. Breakfast Lunch Dinner How much time out of your day do you spend thinking about food? o 50% Please elaborate on your snacking habits (i.e. how often, time of day, foods you choose): What meals and how frequently do you eat at restaurants or get take out each week? What kinds of restaurants do you usually eat at (i.e. Fast food, sit down, specific restaurants)? Please te.

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