Food Questionnaire

Date:
Name:*
Phone:
-
E-mail:
Preferred contact method
Address:
Which meals?
Number of days a week you/family will eat prepared meals?
Number of servings for each meal?
Individually packaged meals or family style
Service frequency
What food styles interest you?
List Other Food Styles
What cuisines do you enjoy ?
List Other Cuisines:
Food Allergies?
Medical issues that affect diet?
Nutritional goals?
Favorite meals?
Foods disliked?
Do you eat sweeteners?
Vegetables - Preferences/Dislikes?
Mushrooms - Preferences/Dislikes?
Fruits - Preferences/Dislikes?
Poultry - Preferences/Dislikes? Chicken, Duck - breasts, thighs, drumsticks, skin-on, bone-in, etc?
Meats - Preferences/Dislikes? beef, lamb, pork, bison
Grains - Preferences/Dislikes? wheat, white rice, brown rice, quinoa, millet, oats, etc.
Fish - Preferences/Dislikes? white fish, oily fish, skin-on, whole, etc.
Dairy - Preferences/Dislikes? milk, cream, butter, cheese, blue cheese, etc.
Shellfish - Preferences/Dislikes? shrimp, lobster, clams, mussels, oysters
Legumes - Preferences/Dislikes? green beans, peas, black, black-eyed peas, field peas, red, kidney, garbonzo, etc.
Soups and stews as a meal?
Salads as a meal?