Wufoo
Client Questionnaire
During our initial interview, we will discuss your dietary likes and dislikes, food preferences, allergies, etc. To aid in preparation, please complete following Questionnaire, being as thorough and specific as possible, so that we can truly customize your experience.
Name
*
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
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Afghanistan
Åland Islands
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Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Phone Number
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Email
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1. SOUPS AND STEWS: As a main dish? Hot? Cold?
2. SALADS: Rice/Pasta/Green Salads
3. PASTAS: Hot? Cold?
4. BEEF: Steaks/Roasts/Ground Sirloin
5. PORK: Roasts/Chops/Ground/Ribs/Bacon/Sausage
6. LAMB: Chops/Stews/Ground
7. CHICKEN: White/Dark/Ground (Skin on or off/Bone in or out)?
8. TURKEY: Breast/Ground
9. FISH: Tilapia/Salmon/Catfish
10. SHRIMP:
11. SHELLFISH:
12. MEATLESS MEALS: Just meatless?/Tofu/Soy products
13. BEANS: Kidney/Lentils/Garbanzo/Pinto/Black/Navy/Soy
14. CHEESE/EGGS:
15. GRAINS: Couscous/Quinoa/Barley/Bulger/Polenta/Risotto/Rice(brown?white)
16. NUTS: Walnuts/Cashews/Almonds/Peanuts/Pinenuts
17. IS IT OK TO USE ALCOHOL (WINES, ETC.) IN COOKING?
18. BREAD PREFERENCES: White/Wheat/Multigrain/Flatbreads/Tortillas
19. WHAT ARE YOUR FAVORITE FOODS?
20. ANY FOODS YOU REALLY DISLIKE?
21. RATE YOUR SPICY FOOD PREFERENCE: Bland/Mild/Moderate/Hot
22. ANY LIMITATIONS ON USE OF SALT AND PEPPER?
23. ANY HERBS & SPICES YOU DO NOT LIKE:
24. USE OF GARLIC/ONIONS/GINGER/OTHER SEASONINGS:
25. DO YOU LIKE OR DISLIKE CERTAIN INTERNATIONAL CUISINES?
Mexican/Thai/Indian/Italian/Asian
26. DO YOU HAVE A GRILL AND WANT MEALS PREPARED FOR COOKING ON IT?
27. DO YOU HAVE ANY FAVORITE RECIPES THAT YOU WOULD LIKE PREPARED?
28. WHAT ARE YOUR FAVORITE RESTAURANTS?
29. ANY OTHER INFORMATION THAT I SHOULD KNOW? Diet/Calorie Guidelines
30. ANY SPECIAL COOKING INSTRUCTIONS?
31. DO YOU HAVE A GROCERY STORE PREFERENCE?
32. DO YOU HAVE ANY PURCHASING RESTRICTIONS? Organic/Clean 15
NOTES:
Do Not Fill This Out