Transcription of Infant/Toddler Diet Questionnaire
{{id}} {{{paragraph}}}
Example: tourism industry
Infant/Toddler Diet Questionnaire
OVER child (2 - 5 years) diet Questionnaire child s Name: _____ child s Birth D ate: ___/___/_____ Today s date: ___/___/_____ 1. Please check all of the following you have that Top Oven Microwave Refrigerator 2. What does your child usually drink? (Please check all that apply.) Milk (including breastmilk) Formula Juice/Juice Drinks Water Sweetened Tea Regular Pop/Kool-Aid Herbal Teas Gatorade/Sports Drinks Other: _____ 3. What does your child drink from? (Please check all that apply.) Breast Bottle Sippy Cup Cup 4. Does your child ever walk around drinking from a sippy cup or a bottle? No Yes 5. How many times does your child drink milk during a normal day? _____ child does not drink milk a. How much milk does your child drink each time? _____ounces b. What type of milk does your child usually drink? Cow s (_____Whole (Vitamin D) _____Reduced/Low Fat (2%, 1% or %) _____Skim) Lactose Free Goat s Evaporated Sweetened Condensed Soy Rice Other: _____ c.
Child Diet Questionnaire 10/2012 12. Which snack foods does your child usually eat? (Please check all that apply.) Child does not eat snack foods
Loading..
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: