A survey on losing weight - 问卷调查调研模板

Q1:What's your sex?

Male

Female

Q2:Your weight:

≤40kg

40kg~45kg

45kg~50kg

50kg~55kg

55kg~60kg

60kg~65kg

65kg~70kg

70kg~75kg

≥75kg

Q3:Are you satsfied with your weight?

Satisfied

Just so so

Not satisfied

Q4:Does weight effect your life?

No

Healthy

Moods

Healthy and moods

Others

Q5:Are you willing to lose weight?

Yes

No

Q6:Why do you want to lose weight?

To be beautiful or handsome

To be slim

Effected by friends around

Better clothing

Others

Q7:Weight loss conditions

At the beginning

Lost weight before but quit it now

Insisting on losing weight

Just want but don't put it into practice

From time to time

Q8:Your ways of losing weight:

A healthy diet

Eat less

Do more exercise

Take slimming products

Others

Q9:If weight loss effect your health, will you insist?

Yes

No

Q10:What do you think of ones figure？

To be more and more thin

Not so bad to be fat

Not necessary to be thin but must be well proportioned

Q11:Wrong concepts on losing weight:

Follow the general trend

Unscientific methods

Unable to insist on

Serious compare phenomenon

Others

Q12:What do you think of losing weight:

选项1

Q13:Your effective ways andexperiencesof losing weight:

选项1