Name
*
First Name
Last Name
Address
*
Email
Date
MM
DD
YYYY
Contact Number
(###)
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What are your top 3 reasons for hiring a personal chef?
What type of cuisines do you enjoy eating?
If other please list here:
Do you or anyone in your home have any known food allergies?
If yes, please be very specific and list below.
Food Allergies
*
Do you have any sensitivity to certain foods, tastes, or textures you dislike?
If other, please list below.
Other food sensitivities:
Are you lactose intolerant?
Are there any health conditions where proper diet is a concern?
Client can explain in more detail during initial consultation.
Do you enjoy spicy foods? If yes, do you prefer:
May I cook with wine, beer, or liquors?
What fruits and vegetables do you like?
Meat Favorites/Cuts?
(Beef, pork, veal, chicken, turkey, lamb, bison, ground meats, other).
Please list below.
If and when you eat poultry, do you prefer:
Fish and Seafood Favorites:
What kind of soups do you prefer?
Do you eat salads as an entree or as a side with your entree?
Favorite Salad Greens:
Do you like pasta dishes that are cold and hot?
What kind of sauce do you like with your pasta?
Do you eat vegetarian or vegan entrees?
What types of grains do you prefer?
Do you eat nuts? If so, what types?
Do you eat cheese? If so, what types?
How often will you need a personal chef service?
Frequency of service:
Would you prefer disposable or reusable containers?
Nearest Grocery Store(s)?
Do you have a functioning microwave oven?
Do you use any special cleansers for your counters/stove tops?
Which appliance are you going to use to heat your meals?
Please list any other comments or concerns:
Emergency numbers and contacts
