Workplace Nutrition Barriers Survey
Tell us about workplace factors that make healthy eating easier or harder so improvements can be identified. Complete all questions based on your current work situation.
Workplace Profile
Employee Role / Department
*
Work Arrangement
*
On-site
Hybrid
Remote
Field-based
Typical Shift Pattern
Day shift
Evening shift
Night shift
Rotating shift
Split shift
Flexible
Other
Primary Workplace Location / Site
*
Nutrition Access Barriers
What workplace-related barriers do you encounter when choosing meals?
*
Limited break time
Lack of nearby food options
Limited fridge or microwave access
High food cost near workplace
Meetings during meal times
Long commute
Vending machine reliance
Other
How often do these barriers affect your meal choices?
*
Never
1
2
3
4
Always
5
1 is Never, 5 is Always
Meal Pattern and Environment
Where do you usually eat the following meals at work?
*
Rows
At desk
Break room
Cafeteria
Off-site
In vehicle
Other
Breakfast
1
2
3
4
5
6
Lunch
7
8
9
10
11
12
Dinner
13
14
15
16
17
18
Snacks
19
20
21
22
23
24
How satisfied are you with the workplace eating environment?
*
1
2
3
4
5
Support and Preferences
Which workplace supports would help you most?
*
More break time
Better food options
Fridge/microwave access
Water access
Nutrition education
Designated eating space
Flexible scheduling
Other
Additional comments or suggestions
Submit Survey
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