8/12/2019 Sample Demographic Questionnaire and Consent Form

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DDEEMMOOGGRRAAPPHHIICCQQUUEESSTTIIOONNNNAA IIRREE

Panelist code: _________ Date:_____________

Please answer all questions by checking the blank corresponding to your answer as truthfully as possible.Your name is not on the questionnaire and will not be identified with your answers. This will be of greathelp for the success of the sensory evaluation of foods. Thank you.

1. In your household, who is the person who buys food and cooks most of the time?Father Mother Siblings Self Others, please specify______ ______ ______ ______ ______

2. What is your date of birth? ___________ What is you age group?18-25 25-30 30-35 35-40 40-45_____ ______ ______ _____ _____

3. What is your gender? Male Female_____ _____

4. What is your marital status?

Single Married Separated/divorced Widowed______ ______ ______ ______

5. How far did you go in school?_____Less than 7 years of school_____High school_____College_____Graduate School_____Post-graduate

6. Please check the one that best applies to you:_____Employed full-time _____Employed part-time_____Homemaker _____Student

_____Unemployed _____Disabled

7. What is your monthly family income?_____>300,000 pesos_____101,000-300,000_____51,000-100,000_____15,000-50,000_____

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CCOONNSSEENNTTFFOORRMM

I, _____________________, agree to participate in the sensory evaluation of ______________,which is being conducted by __________________ of the College of Home Economics, UP Diliman,Quezon City.

I understand that my participation is entirely voluntary. The following points have been explained:

Sensory evaluation will be conducted on_____________. During the sensory evaluation, I willtaste the coded samples that will be presented to me and I will write my evaluation on the scoresheets provided. All procedures used in sensory evaluation are standard methods as publishedby the American Society for Testing Materials (1968).

No discomforts or stresses are foreseen during sensory evaluation.

Participants entail the risks of developing an allergy to the test for sample. However, because thetest food product is known beforehand, this situation can normally be avoided. In the event of anallergic reaction unknown to participants and their families, medical treatment is available bygoing to the nearest health facility. In the event that my participation in this study results in amedical problem, treatment will be made available. I, or my insurance company, will be billed forthe costs of any such treatment. I understand that no provision has been made for payment ofthese costs to provide me with any other financial compensation.

It is my responsibility to make known to the investigators any food allergies that I may have. Ialso understand that I must inform the investigators if I have any allergies towards________________(Allergies: __________) Witness signature over initials: ______________

The results of this participation will be confidential and will not be released in any individuallyidentifiable form without any prior consent unless required by law.

The investigator will answer any further questions about the study, either now or during thecourse of the project.

My signature below indicates that the researchers have answered all my questions to mysatisfaction and I consent to volunteer for this study. I have been given a copy of this form

____________________ ____________________Signature of Investigator Signature of Participant

Witness:____________________ Date:________________

PLEASE SIGN BOTH COPIES KEEP ONE AND RETURN THE OTHER TO THEINVESTIGATOR

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Preparation of Samples

ORANGE JUICE (IN TETRA PACKS)

1. Upon purchase, cover the package with aluminum foil or masking tape .

2. Label the covered products with a waterproof marker.

3. Store the products at refrigerated temperature (4-6oC).

4. Prior to evaluation, place 30-ml samples in pre-coded sample cups with lid.

5. Samples not to be served immediately will be stored at the refrigerator. It will only be taken out if

the samples are ready to be evaluated.

6. Serve samples as written in the Master Sheet. These products are best served monadically

(individually). Only when the first sample had been evaluated, can the second sample be served.

POWDERED ICED TEA

1. Upon purchase, cover the package with aluminum foil or masking tape .

2. Label the covered products with a waterproof marker.

3. Prior to evaluation, add appropriate volume of cold water, then place 30-ml samples in pre-coded

sample cups with lid.

4. Samples not to be served immediately will be stored at the refrigerator. It will only be taken out if

the samples are ready to be evaluated.

5. Serve samples as written in the Master Sheet. These products are best served monadically

(individually). Only when the first sample had been evaluated, can the second sample be served.

FISH BALL

1. Upon purchase (at least a day before actual evaluation), cover the package with aluminum foil or

transfer to a plastic container.

2. Label with a waterproof marker.

3. Store the products at freezing temperature (18- 0oC) if not to be used immediately.

4. If the samples will be used the following day, place the products in the refrigerator for thawing.

Thawing at refrigerated temperature (4-6oC) takes approximately 18-24 hours to be completed.

5. After complete thawing (no ice crystals present), remove excess water from the package

6. Pre-heat a deep pan for frying. Place a pre-determined volume of oil to cover 1 pack of fish ball

7. Heat oil to 170-190o

C then add the fish ball,fry until golden brown or completely cooked. Take noteof the time of cooking.

8. When the samples are cooked, drain oil. Line the plate of the samples with tissue paper to remove

excess oil.

9. Slice the balls into 2 and place 3 sliced pieces (30g) of fish ball into pre-coded sample cups with lid.

10. Serve the samples to panelists either monadically or all at the same time.

Note: Different samples may be cooked simultaneously using various pans strictlyfollowing the above method. Reusing of oil is not advisable because reused oil may have

residual flavors and odors thus may affect the sensory attributes of the samples that will becooked in reused oil.

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