General
 
FSA/Postal Code:
 
# of Postal Codes:
Average House Price:
 
Rural?:
 
Nearest City:
 
Nearest Highway:
 
Bus Frequency:
 
Subway Frequency:
Tobacco
 
Point-of-Sale Advertising:
 
Openly Displayed Cigarettes:
 
Signs that Prohibit Smoking:
 
Signs Showing Harmful Effects:
# Cigarette Brands sold?:
# Smokeless Tobacco Brands?:
 
Available Packet Sizes:
Cheapest Brand Sold:
Marlboro Brand Sold:
# of Health Warning on Cheapest Pack:
 
Smoking Cessation Aids Sold
Groceries
 
Junk Food Advertisment:
 
Sweet Drink Advertisment:
 
Fruit and Vegetable Advertisment:
 
Cigarette and Tobacco Advertisment:
 
Alcohol Advertisment:
# of Types of Fruit:
 
3+ Fruits Appear to be Damaged:
 
3+ Fruits are Specially Packaged:
# of Types of Vegetables:
 
Healthy Food Basket
 
Junk Food Combination
Restaurants
 
Salads as Main Dish:
 
Increase Portion Size Option:
 
Buffet Service:
 
Health Check Items:
 
Nutritional Information Provided:
Alcohol
 
Store Sells Alcoholic Beverages?:
 
Price of a 750-ml Bottle of White Wine?
 
Price of 24-Cans of Beer?: