Thank you for your interest in this questionnaire, which will be part of a dissertation for a Human Nutrition degree. Please take part if you are over the age of 18, live in the UK and have any adverse reaction to food. By submitting your answers you are agreeing to the use of your data for this study. No personal information is required so data will remain anonymous. Any question you are not happy to answer can be ignored. If you wish to contact me about any aspect of this study please email me on: holly.chant09@bathspa.ac.uk

1.	Do you suffer from an 'adverse food reaction', which is defined as: any abnormal symptom after the ingestion of food?
	Yes
	No

2.	Is your food reaction an:
	Allergy
	Intolerance
	Unsure

3.	Which foods give you a reaction? Select all that apply
	Cow's milk
	Eggs
	Peanuts
	Sesame Seeds
	Shell fish
	Fish
	Wheat
	Other

	If other please specify

4.	What symptoms do you get from this reaction? Select all that apply
	Nausea or vomiting
	Abdominal Pain
	Migraines
	Breathing Problems
	Skin Rash
	Anaphylactic shock
	Other

	If other please specify

5.	Has your food reaction been medically diagnosed?
	Yes	Go to 6.
	No	Go to 7.

6.	If yes by a..
	NHS Health Practitioner
	Allergy Specialist in Hospital	Continue to 8.

7.	If no - has your food reaction been diagnosed by:
	An alternative Health practitioner
	No diagnosis	Continue to Q8

	Please explain what you mean by an alternative health practitioner

8.	Have you had any medical tests to diagnose or investigate your food reaction?
	Yes	Go to Q9
	No	Continue to Q10

9.	If yes -
	Skin Prick Test
	Food Challenge
	Unsure
	Other

	If Other Please specify

10.	Do you carry an "Epipen" in case of a reaction?
	Yes
	No

11.	Which food or food groups do you cut out from your diet due to your food reaction? Select all that apply
	Dairy Products
	Meat
	Eggs
	Peanuts
	All Nuts
	Fish
	Wheat
	I do not cut out any foods
	Other

	If other please specify

12.	Have you seen a medical professional to assist you with any diet changes you have made?
	Yes
	No

13.	Has a medical professional diagnosed you with another illness as a reason for your adverse food reaction? e.g Irritable bowel syndrome
	Yes	Go to Q14
	No	Continue to Q15

14.	If yes - Please explain

15.	Do you feel medical professionals offer you appropriate informtaion or support to assist you with your food reaction?
	Yes	Continue to Q17
	No	Go to Q16

16.	If no - Which other sources have you used for information? Select all that apply
	Friends and Family
	Books
	Newspaper Articles
	Internet pages such as: NHS, Boots
	Internet support forums
	No other sources
	Other

	If other please specify:

17.	Do you feel your adverse food reaction has an impact on your everyday life?
	Yes	Go to Q19
	No	Continue to Q20

19.	Please show how your food reaction effects your everyday life
	My food reaction has a	Strong positive impact		Positive impact		No impact		Negative impact		Strong negative impact
	Continue to Q20

20.	Is there anything else you would like to tell me about your adverse food reaction?

Just a couple of questions about you:

21.	Age:
	18-25
	26-30
	31-40
	41-50
	51-60
	60+

22.	Gender
	Male
	Female

Thank you for taking the time to complete this questionnaire :)