Nutritional Assessments

Dear Nutritional Analysis Participant:

 Thank you for your interest in the Health Education Resource Center’s (HERC) Nutritional Analysis program!  I look forward to providing you with a very pleasant and educational experience, and am excited to work with you towards healthy nutrition and lifestyle goals.

Included in the Nutritional Analysis (NA) packet are several forms that need to be filled out and returned to the HERC at your earliest convenience.  These forms include a Confidentiality Consent and Nutritional Analysis Form with a 3-Day Food Record.   

     Confidentiality Consent: This gives Eastern Illinois University and the Nutrition Education Coordinator permission to perform a Nutritional Analysis on you.  This form also gives us permission to send your analysis results to the Eastern Illinois University Health Service, Counseling Center and/or Eating Disorder Team depending on your results, while keeping your information confidential.

    Nutritional Analysis Form: This form gives us some basic information about you, your nutrient intake, and physical activity patterns.  This form will provide the Nutrition Education Coordinator with pertinent information needed to complete the analysis. 

    3-Day Food Record: This form is included in the Nutrition Analysis Form and is used to assess your current nutrient intake and provides us with general information about your eating patterns.  Remember the result of your 3-Day is only as accurate as your measurements.

Together we can work to achieve your nutrition goals! 

If you have any questions, feel free to contact the Nutrition Education Coordinator at 217.581.7786. 

Best regards,

Dawn Wilcox

Nutrition Education Coordinator

Health Education Resource Center

Phone: 217.581.7786

Fax: 217.581.8330

Email: dswilcox@eiu.edu