| Overview | Program Resources | Submit Resources | Search Resources |

Thank you for submitting your resource for consideration - only resources that are available online may be posted.

Please complete the following information that will accompany the resource review.

• It is important that you answer all questions, since resource reviewers will use the information on this form in the review process.
• Missing information can affect the outcome of the review.

• Targeted to consumers, or health intermediaries or food industry
• Resource can be found online at a website. Some examples include factsheet/pamphlet, quiz, interactive tool or game, FAQs, policy document, guidelines, literature reviews, educational program or course
• Canadian resource that is based on mandatory nutrition labelling policy introduced in Dec, 2005

Your time, expertise, and attention to detail are appreciated.
Your efforts here contribute to credible healthy eating information being available to more Canadians.

All fields marked with (red dot) are required.

RESOURCE INFORMATION
Name of Resource
URL for Resource (do not include http://)
Year resource was created	yyyy
Name of developer/publisher of the resource
Name of person submitting resource
Contact Email
Contact Phone
Do you know of any experts for reviewing material on this topic? If so, please list their names and contact information (phone number or e-mail address) below.

BACKGROUND ON RESOURCE
Description of Resource (Provide an overview of what the resource is about and include the literacy level)
Keywords - Enter all keywords related to the nutrition labelling content covered in this resource, such as, Nutrition claims, Calories, Serving size, % Daily Value, and Ingredients (Please separate each keyword with comma)
1. The publisher/owner of the resource is: (select one)
Not-for-profit e.g. Association, Foundation Government e.g. Health Unit Partnership between Government and Non-for-profit e.g. Dietitians of Canada and Health Canada Private sector e.g. Food or Pharmaceutical Company Partnership between private sector and government Partnership between not-for-profit and private sector
2. (a) The author(s) of the resource is (are): Please select one of the following. Then provide details about the author(s) in #2b.
Individuals with professional qualifications (related to the topic) Organization(s) providing information within their areas of expertise The source is not professionally or legally accredited authority, but is providing an informed perspective e.g. Parents of a picky eater; Support Group
2. (b) The background and/or credentials of the author(s) are the following:
3. If you know the history of how this resource was developed please provide the following information: a brief history of the development process of the resource, include the review process and who was involved, pilot testing with target audience, etc. If you do not know the background of the development of this resource, please skip to question 4.
4. Has this resource been reviewed by experts in the topic area?
YesNoUnknown
5. What key references/source(s) of information was the resource content based on?
6. Type of Resource: (Select one)
Select... Application Ideas/Experience Audio/Visual/CD Book Course Directory Discussion/Points of View Evaluation/Assessment Tool Fact Sheet/Pamphlet FAQ(Frequently asked question) Game/Quiz/Interactive Tool Information Request (e.g. HIR) Manual/Guide Menu Plan Monitoring Report Newsletter Article/Journal Newspaper/Magazine Features News Release Phone Line (e.g. Dial a Dietitian, Telehealth) Position Paper/Policy Document Poster PSA Practice Guideline Recipe Story/Script Strategy Tips Topic Overview Web Site Research Report/Paper Research Abstract Partnership Profile Other
	If Other:
7. Resource is designed to be used by/intended audience:
Health Intermediary e.g. Teaching resource Consumer e.g. Fact sheet or client handout (Please elaborate) Adults: All Adults Men Women Seniors Children: All children(0-12 yr.) Infant(0-2 yr.) Preschool(3-4 yr.) School age(5-12 yr.) Youth(13-17 yr.) Aboriginal People Ethnic Groups People with Special Needs (Those who have a physical, sensory or learning disability or difficulties in areas such as communication, attention or behaviour.)
8. Content of this resource provides information ABOUT which target group:
Adults: All Adults Men Women Seniors Children: All children(0-12 yr.) Infant(0-2 yr.) Preschool(3-4 yr.) School age(5-12 yr.) Youth(13-17 yr.) AboriginalPeople Ethnic Groups People with Special Needs
9. Please provide any additional details about the resource:
Nutrition and Lifestyle Healthy eating/General nutrition Healthy weight Clinical Nutrition Cardiovascular disease/Heart disease Diabetes/Glucose intolerance Food allergies/Intolerance Obesity/Weight control Food Nutrient Issues Food fortification/Enrichment Food groups Food labelling Food preparation/Cooking Food regulations Food selection/Purchases Nutrients - Antioxidants (Vitamin C, Vitamin E, Selenium and Carotenoids) Nutrients - B Vitamins and Choline Nutrients - Calcium and related bone nutrients (Phosphorus, Magnesium, Vitamin D, Fluoride) Nutrients - Electrolytes and Water (Sodium, Potassium, etc.) Nutrients - Macronutrients (Protein, Fat, Carbohydrate, etc.) Nutrients - Macronutrients - Carbohydrate Nutrients - Macronutrients - Fat Nutrients - Macronutrients - Protein and Amino Acids Nutrients - Micronutrients (Vitamins A, K, Iron, Magnesium, etc.) Nutrition recommendations/Guidelines/Food Guides
10. Target region for this resource:
Select... All Alberta Atlantic Provinces British Columbia Manitoba New Brunswick Newfoundland and Labrador Northern Territories Northwest Territories Nova Scotia Nunavut Ontario Prairies Prince Edward Island Quebec Saskatchewan Yukon Canada United States International
11. Language of Resource:
EnglishFrenchOther
12. Does the Web design allow use by the seeing impaired or are there options present to allow use by the seeing impaired?
YesNo
13. Format: (select one)
Viewed Directly Online Requires separate program to view/open content of resource PDF Word Processor (e.g. Word, Word Perfect) Other (e.g. animation, audio)