Gluten Free Casein Free Diet Questionnaire - Never used GFCF Diet

Answers marked with a * are required.

1. Parent Survey - Never tried GFCF diet

1. What has stopped you from trying the GFCF diet with your child? (choose the strongest reason) *

I don't think there will be significant improvement in my child's life by a diet change.

The GFCF diet is too expensive.

The ingredients and foods for the GFCF diet are very difficult to find.

The ingredients and foods for the GFCF diet don't taste good.

I'm worried that my child will not eat the foods required for the GFCF diet.

Other (Please Specify)

2. Would you consider using the GFCF diet with your child? *

Yes.

No.

Maybe.

3. What would you need to attempt the GFCF diet with your child?

4. What foods does your child commonly eat? *

5. Would you like us to contact you about the potential to have GFCF foods and ingredients available for delivery or pick up in your area? If so, please type your e-mail address in the space below.


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