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Food Questionnaire

Here is your opportunity to let me know what you prefer in your customized menu. Check preferences and add comments, as needed. Be sure to tell me if there are allergies or foods you NEVER want to see!

 *Olive oil is used most often in cooking, with occasional uses of other oils (walnut, sesame, peanut, etc.). Butter is also used occasionally. A canola oil cooking spray is also used.

**All grains will be whole grain, unless otherwise specified.

* Required fields
Name *
E-mail Address *
City *
Telephone *
What type of diet are you looking for?
Any
Vegan
Low Calorie
Vegetarian
Low-fat
Low Cholesterol
Special Diet (Diabetic, Gluten-free, Lactose-intolerant, etc.)
Other
Other (specify)
Meats
Beef
Veal
Pork
Lamb
Meatloaf
Casseroles
Comments
Poultry
Chicken
Turkey
Meatloaf
White meat
Dark meat
Both
Seafood
Fish
Scallops
Crab
Shrimp
Comments
Salads
Fresh Green
Fruit
Pasta
Main Dish
Salad Dressings Use your own
Made by chef
Comments
Soups
Creamed
Cold
Hot
Chunky
Comments
Vegetables
Green(peas, green beans, spinach or other greens, asparagus, cabbage, celery, etc.)
Red (pimento, red cabbage, beets, tomatoes, sweet potatoes, etc.)
Yellow (corn, wax beans, squash, etc.)
White (cauliflower, potatoes, parsnips, onions, mushrooms, leeks, etc.)
Beans (black, pinto, garbanzo, etc.)
Peppers (sweet, hot)
Comments
Fruit
Citrus
Stone
Berries
Fresh
Dried
Preserves
Cooked in a main dish
Comments
Grains
Rice
Quinoa
Couscous
Corn
Wheat
Whole Grain
Refined
Comments
Breads (Whole Grain, unless otherwise specified)
Biscuits
Rolls
Cornbread
Tortillas
Comments
Seasonings
List any herbs or spices you don't want, including garlic, pepper or low-salt
Milk and Milk Products
Cheeses (parmesan, cheddar, swiss, goat, etc.)
Sour cream
Yogurt
Milk
Percent Fat Non-fat
1%
2%
Whole
Eggs Whole
Whites only
Yolks only
Substitute
Other
Tofu
Nuts (pecans, almonds, walnuts, etc.)
Favorite Cuisines
Mexican
Italian
Indian
Asian
Other (specify)
Breakfast (Whole grain unless otherwise specified)
Waffles
Muffins
Quiches
Do you prefer mild, moderate, or hot spiciness?

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