8/16/2019 CAR Questionairre

1/4

1-2 hrs Mother Oatmeal3-4 hrs Father Cereal

5-6 hrs 8 Brother Eggs7-8 hrs 4 Sister Panca es8! hrs 1 "#nt Oranges

$ncle "%%les&ran'mother 3 Pear&ran'(ather 2 Pastries&reat &ran'(ather 1 OtherOther)one *

+o, man ho#rs o(slee% 'o o# get %er

night

"re o# a,are o( an (amilmem.ers ,ith t %e 2

'ia.etes/hat 'o

.rea

8/16/2019 CAR Questionairre

2/4

1 Pi00a 11 Broccoli 55 B#rgers 1 S%inach 1

8 +ot'ogs 1 Ca..age *2 French Fries 12 ett#ce 12

Frie' Chic en * omatoes 71 )one Beet 1

)one23

o# eat (or(ast

/hat (ast (oo's 'o o#eat

/hat egeta.les 'oo# eat

8/16/2019 CAR Questionairre

3/4

8/16/2019 CAR Questionairre

4/4

s inner4 Ba e' Beans2 Pasta 1

7 Beans 1* Fish 1

o(#5 S%lit Peas 54 Chic %eas2 Por 83 ice 135 )one

3