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DIET SELFEVALUATION WORKSHEET Nutritional Solutions Jeanne M. Wallace, PhD, CNC Michelle Gerencser, MS Patrice Surley, MH, NC This worksheet can help you assess the anticancer power of your diet so.

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How to fill out the Patrice Surley online

The Patrice Surley online form is a valuable tool for evaluating the anticancer power of your diet. This guide will help you navigate each section of the form effectively to assess your nutritional strengths and identify areas for improvement.

Follow the steps to complete the form accurately.

  1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
  2. Begin by entering your name and the date on the designated lines at the top of the form. Ensure this information is accurate as it will help in tracking your progress.
  3. For each item listed in the worksheet, carefully review your typical dietary intake and select the response that best describes your eating habits by circling the appropriate answer.
  4. Use a food journal from the past week to reference your actual consumption patterns, which can aid in providing accurate responses.
  5. Pay special attention to the 'Areas to Improve' section, where you will mark how often you consume various food groups, such as fruits, vegetables, and other suggested items.
  6. After completing each section, review your selections to ensure they reflect your eating habits clearly. Adjust any responses as necessary.
  7. Once you have filled out the entire form, save your changes, and consider downloading or printing the document for future reference.
  8. Plan to complete this worksheet again in the future using a different color ink to monitor your dietary progress effectively.

Begin your journey to better nutrition by filling out the Patrice Surley online form today!

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MD Solitication No F10B1400010 2011 MD WCC H28R 2008 ME Me. B-9.3 2010 ME WCB M-1 1999

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