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Fakulti Sains Kesihatan Faculty of Health Sciences

EVALUATION FORM – THERAPEUTIC DIET LAB REPORT

Student’s Name : ____________________________ Matrix No: _______________

Student’s Name : ____________________________ Matrix No: _______________

Case: ________________________________

Menu Prepared: Malay / Chinese / Indian / Western

No Criteria Mark Maximum

Introduction
 Comprehensive
1. 5
 Correct nutrition assessment

Dietary management
 Suitable dietary objective and diet modification principles
 Appropriate energy requirement and macronutrient
2. 15
distributions
 Appropriate exchange table

Menu plan & modifications


 Appropriate menu planning & selection
 Practical for the subject to prepare & availability of the
3. 15
ingredients
 Considerations of lifestyle and sociodemographic profiles

Cooked menu
 Recipes & menu analysis of the foods prepared
4.  Discussion on the cooked menu (i.e. recommendations 10
during presentation)

Teamwork
5.  Work distribution & description 5

TOTAL 50

Overall Comment : ___________________________________________________

__________________________________________________

Assessor : ___________________________ Date : ______________


Program Dietetik
Fakulti Sains Kesihatan, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
Telefon: +603- 9289 7511/7543 Faksimili: +603-2694 7621 Laman Web: http://www.fsk.ukm.my

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