Juice PLUS+ Children's Health Study

Enrollment Questionnaire

Thank you for agreeing to participate in the Juice Plus+® Children's Health Study.

The Study is designed to determine what effect adding Juice Plus+® fruit and vegetable capsules and/or chewables to the family diet can have on children's health.

The Enrollment Questionnaire is designed to provide us with some basic information prior to the time you and the child begin to take Juice Plus+®:

  • information about YOU and the CHILD you are sponsoring

  • information regarding the CHILD'S DIET and overall HEALTH

Thank you in advance for taking a few minutes to fill out this Enrollment Questionnaire now.

  • Your responses are completely confidential.

  • Please be honest in all your responses. Diet and nutrition are a challenge with most parents today. Honest responses are key to assuring the validity of our Study.

Your next Health Study Questionnaire will arrive with your SECOND four-month supply of Juice Plus+®.

Privacy Statement

The Juice Plus+® Company, LLC respects the privacy needs of people who respond to our surveys and we are committed to maintaining the privacy and security of personal information. The personal information you provide is confidential and is combined with information gathered from other survey participants, and reported in aggregate. The information you supply will be used by The Juice Plus Company+® for statistical purposes only within the Children Health Study that you agreed to participate in.