Food Questionnaire

Client Name *

First

Last

Other Adults

Children - Names and Ages

Pets- Names and Types

Birthdays

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

How Did You Hear About True Culinary? *

Meats

Preference on How Steak is Cooked

Medium Rare
Medium
Medium Well

Comments

Poultry

Chicken (breasts/thighs/ground, etc.)
Turkey (breasts/smoked/ground, etc.)
Chicken or turkey meatloaf
Chicken or turkey and vegetable/pasta casseroles

Preference on Type of Chicken Meat

White
Dark
Mixed

Comments

Salads

Fresh Green Lettuces: Romaine, red leaf, bibb, kale, cabbage, spinach, arugula etc.
Fruit in your salad
Pasta in your salad
Salads as a main dish

Comments

Salad Dressings

Creamy Ranch, Caesar, Blue Cheese
Vinaigrette (any)
Third Choice

Comments

Soups/Stews

Creamy or Chunky (Preferred type/name)
With meat/poultry
Soups/Stews/Chili as a main dish

Comments

Vegetables

Green (peas, green beans, spinach, asparagus, peppers, cabbage, pea pods, celery, brussels sprouts, bok choy, peppers, asparagus, mustard greens/greens, broccoli, zucchini, avocadoes, okra)
Yellow (corn, wax beans, squash, butternut squash, spaghetti squash, peppers)
Red (tomatoes, red cabbage, beets, radish, peppers, sweet potatoes, carrots)
White (cauliflower, potatoes, parsnips, water chestnuts, bamboo shoots, bean sprouts, onions, mushrooms, leeks, turnips, hearts of palm)
Beans (black, pinto, kidney, lima, white, pink, black-eyed peas, split peas)
Other (capers, black olives, green olives, pickles, artichokes, anchovies, eggplant)

List Vegetables You Won't Eat

Comments

Seasonings

Pepper—white, black or red
Salt—Kosher
Basil, oregano, sage, rosemary, tarragon, fennel, cumin, cilantro, paprika, smoky paprika, parsley, celery, chili powder, onion powder, curry, masala, ginger

List Any Seasonings that You Won't Eat

Fresh Herbs

Parsley, cilantro, dill, basil, green onion, thyme, sage

Comments

Fats/Oils

Butter
Olive Oil and other healthy oils (sesame, walnut, coconut, avocado, truffle, rice bran)

Comments

Milk/Milk Products

Cheeses (parmesan, cheddar, Swiss, muenster, fontina, blue, feta and goat etc.)
Milk (skim, 1%, 2%, whole, cream)
Yogurt
Sour cream

List Any Cheese or Dairy You'd like to Avoid

Eggs

Whole
Whites or Yolks Only

Comments

Other

Tofu or Meat Substitutes
Dried Fruits
Nuts (pecans, peanuts, walnuts, almonds, cashews, macadamia, pine nuts, Brazil)
Seeds (sesame, sunflower, pepitas/pumpkin, flax, chia)

List Any Fruits You Dislike (If Any)

List Any Known Food Allergies/Sensitivities

May We Cook with Alcohol?

Do You Have any Favorite Recipes We Can Prepare for You?

Favorite Cuisines (Italian, Mexican, Chinese, French, Thai, Japanese, South-West, Cajun)

Favorite Foods/Restaurants

Number of Days Per Week You/Your Family Will Eat Prepared Food

Number of Servings for Each Meal

Portion Sizes

Small
Regular
Larger

Portion Control

Type of Produce

Organic
Non-Organic

Comments/Questions

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