Your relationship with the Coeliac desease:

  Coeliac   Relative

1) Age

2) How old were you when diagnosed?

3) Who diagnosed it?

  Family doctor   Pediatrician   Gastroenterologist
  Others: who?   

4)In total, how many members of your family are celiacs?

5)Are you member of any Coeliac Assosiacion?

  Yes   No If yes, which one?   

6) Do you keep informed on the coeliac disease?

  Yes   No If yes, which is your source?   Assosiation   Internet   Doctor   Magazines
  Others   

6.a) In internet, tell us your favorite websites?

www. www. www. www.

7) Do you buy or receive any specialized magazine?

  Yes   No If yes, which one? 1. 2. 3. 4. 5.

8) In what type of store do you usually buy gluten free food?

Department Stores / Hypermarkets 1. 2. 3. Periodicity   Every week   Once every month   Occasionally Supermarkets Periodicity   Every week   Once every month   Occasionally Other stores   Dietetics Stores   Farmacies   Free from Stores   Bakery Periodicity   Every week   Once every month   Occasionally

9) Do you usually find the products you need?

  Yes   No If it's not, what is missing?

10) Do you usually buy gluten free products at the same store?

  Yes   No

11) Which are the products you usally buy?

Bread	Type:
Pastries	Type:
Pastas	Type:
Sweets	Type:
Snacks	Type:
Cereals	Type:
Others	Type:

12) Which brand do you usually buy?

   Proceli   Schär   Store Brand
  Glutafin   Free from (Tesco)
  Others   What other brands do you buy?   Proceli   Schär   Store Brand
  Glutafin   Free from (Tesco)
  Otros  

13) Which products do you think should be removed from the market due to it's quality problems?

14) What is your most suitable product format?

  Big portions, adapted to my family consumption or frequent consumption.   Smaller portions, one pack for each consumption moment.

15) Regarding other alergies, you positively appreciate gluten free products and…

  egg free   milk free   egg & milk free   I can eat egg & milk

16) Score your knowledge on coeliac disease

  High   Medium   Low

17) Score your needs on obtaining more information about Coeliac Disease

  High   Medium   Not interested

18) If you have any suggestions, go ahead!

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  Yes, I'd like to reveibe more information about Proceli