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The Health Passport Programme
Please complete during week 1
*
Indicates required field
Family Reference (This will be C or D followed by a number)
*
Do you have a hand blender to use of the project?
*
Yes, we have one
No, we do not have one
So that we know who to accept into the Closed Facebook group, please let us know the name of the Facebook account you will be using.
Facebook account name
*
We want to know if our project is has an impact on the amount of fruit each child on the programme eats.
Child 1 should be the main child who will be participating on the programme.
Name & age of child 1 participating on the project
*
How many days last week did child 1 eat fresh fruit
*
Everyday
Most days
About 3 days
Once
Not at all
Name & age of child 2 participating on the project
*
How many days last week did child 2 eat fresh fruit
*
Everyday
Most days
About 3 days
Once
Not at all
Name & age of child 3 participating on the project
*
How many days last week did child 3 eat fresh fruit
*
Everyday
Most days
About 3 days
Once
Not at all
Name and age of child 4 participating on the project
*
How many days last week did child 4 eat fresh fruit
*
Everyday
Most days
About 3 days
Once
Not at all
Submit