Thanks for joining the Challenge! We know it will be a success if you simply stick to a 10” plate for the largest meal of each day for one month. You may even want to commit long-term. We just have a few simple questions to get a feel for your goals and track the number of people that are involved so our “spoon thermometer” can grow to reach our goal.

1. When do you eat the largest meal of the day?  Lunch Dinner

2. What size of plate do you currently use (to the nearest ¼ inch)? inches 

3. What is the brand of your current plate?   

4. What plate do you plan to use (to the nearest ¼ inch)? inches   Brand

5. What is your first name?

6. What is your email address? (If you would like encouragement and/or tips, please share your email….it will be completely  confidential and we promise we won’t spam.

7. Would you like to be contacted with encouragement during your 1 month challenge? Yes   No

8. What is your zip code?

9. What is your height? ft,  inches

10. What is your current weight? lbs.

11. Optional: Waist circumference inches

12. Are you interested in losing weight?  Yes   No

13. How much weight would you like to lose to be satisfied with your weight? lbs.

14. How much weight would you like to lose to be happy with your weight? lbs.

15. What is your top “behavior change” goal you’d like to make for 2009? Hint: make it something attainable… besides the small plate challenge (SPC).