Food Questionnaire Here is your opportunity to let us know what you prefer in your customized menu. Please check preferences and add comments. Please don't hesitate to let us know of any foods or cuisines you do not want to see! Name* First Last Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Protein*Please select the proteins you like Select All Beef/Lamb Chicken Pork Turkey Eggs Cheese Milk/Dairy Shrimp Shellfish Fish Tofu CommentsPlease list any allergies or other comments/dislikes.Grains and Beans*Please select the grains and beans you like Select All White Rice Brown Rice Quinoa Bulgur Barley Black Beans Pinto Beans White Beans Lentils CommentsPlease list any allergies or other comments/dislikes.Vegetables and Fruits*Please note any vegetables or fruits you are allergic to. Please note any vegetables you dislike.Do you like salads as a main Dish?* Yes No Do you like soups as a main Dish?* Yes No Spice Tolerance*Please rate your tolerance for spicy food. No spice Mild Medium Hot Extra Hot Nuts*Please select the nuts you like. Select All Peanuts Almonds Cashews Walnuts Hazlenuts Pinenuts Comments - NutsPlease list any nut allergies or other comments/dislikes.Bread preferencesPlease list any allergies or other comments/dislikes.International Cuisines*Please list any international cuisines you do not like.Do you have any favorite recipes or dishes you would like me to make? CommentsPlease let us know if you or your family have any other dietary considerations.
