New Client Questionnaire

Client Questionnair Form

This form is for Client Use Only. Please Do Not Solicit!

Here is your opportunity to let us know what you prefer in your customized menu. Please check preferences and add comments. Mark with an check mark any foods that you don’t like and never wish to see. Please do not mark the ones you like.

*Client Name: *Your address: *Phone number Fax Number: *Email Address: Meats that you don't like:
Beef (steak/roasts/ground round)
Pork (chops/roasts/ribs/bacon/ham/ground)
Veal (stew/ground/scallops)
Lamb (chops/stew/ground/roasts)
Meatloaf/Meatballs
Meat and vegetable/pasta casseroles
Enter Comments about above Meats. Your likes and dislikes:
Poultry that you don't like:
Chicken (breasts/thighs/ground/etc.)
Turkey (breasts/smoked/ground/scalloped/etc.)
Chicken or turkey meatloaf
Chicken or turkey and vegetable/pasta casseroles
Stuffed Chicken Breast
Cornish Game Hens
Enter Comments about above Poultry. Your likes and dislikes:
Fish/Shellfish that you don't like:
Fish (sole, bass, yellowtail, orange roughly, Trout, catfish, snapper)
Shrimp
Scallops
Crab
Lobster
Tuna (Fresh, canned, in oil or water?)
Salmon
Tilapia
Enter Comments about above Fish. Your likes and dislikes:
Salads that you don't like:
Fresh Green (choice of greens/lettuces, such as Romaine, red leaf, bibb, mixture, spinach, etc.)
Fruit
Rice
Pasta
Jello
Salads as a main dish?
Enter Comments about above Salads. Your likes and dislikes:
Salad Dressings or Sauces that you don't like:
Mayonnaise
Ranch
Vinaigrette
French
Olive Oil/vinegar
Red wine/vinegar
Thousand Island
Miracle Whip
Ketchup
Sweet Pickles/Pickle relish
Dill Pickles/Pickle relish
Soy Sauce
Stake sauce
Enter Comments about above Salads Dressings. Your likes and dislikes:
Soups that you don't like:
Creamed Soups
Hot
Cold
Chunky
Clear
With meat/poultry?
Soups as a main dish?
Meatless Soups
Enter Comments about above Soups. Your likes and dislikes:
Vegetables that you don't like:
Green (peas, green beans, spinach, asparagus, peppers, cabbage, pea pods, celery, mustard greens)
Yellow (corn, wax beans, squash, peppers)
Red (pimento, red cabbage, beets, tomatoes, peppers, sweet potatoes/yams)
White (cauliflower, potatoes, parsnips, water chestnuts, bean sprouts, onions, mushrooms, leeks)
Beans (black, ranch-style, pinto, kidney, lima, white, pink, chili beans)
Enter Comments about above Vegetables. Your likes and dislikes:
Grains that you don't like:
Pasta
Rice
Couscous
Quinoa
Wheat/granola
Corn
Flaxseed
Oats
Enter Comments about above Grains. Your likes and dislikes:
Breads that you don't like:
Wheat
White
Rolls (white or wheat, sour dough, etc.)
Biscuits
Cornbread
Muffins
Pancakes
Waffles
Tortillas
Stuffing
Rye
Sour Dough
Sweet
Enter Comments about above Bread. Your likes and dislikes:
Seasonings that you don't like:
Dried Italian Seasoning, oregano, rosemary, Italian parsley and basil
Chili powder, Cilantro, and Cumin
tarragon and fennel
Paprika
Fresh garlic, parsley, basil, Cilantro
Pepper—white, black or red
Salt—regular, Kosher or Sea Salt
Cinnamon or Nutmeg
Enter Comments about above Seasonings. Your likes and dislikes:
Fats/Oils that you don't like:
Butter
Margarine
Canola Oil
Corn Oil
Olive Oil
Vegetable Oil
Sunflower Oil
Peanut Oil
Lard
Shortening
Enter Comments about above Fats/Oils. Your likes and dislikes:
Milk and Milk Products
Cheeses (parmesan, cheddar, Swiss, muenster, fontina, etc.)
Milk (skim, 1%, 2%, whole)
Cottage cheese
Yogurt
Sour Cream
Half and half
Enter Comments about above Milk products. Your likes and dislikes:
Eggs that you don't like:
Whole
Yolks only
Whites only
Eggbeaters substitute
Over easy
Well Done
Over medium
Other items you don't like:
Cakes
Cookies
Pastries
Ice Cream
Puddings
Regarding the above please List your likes and dislikes:
List any vegetables or fruits you don’t ever want to see?
List any other food dislikes?
List any known food allergies?
Rate your preference for spicy foods - bland/mild/moderate/very?
Bland
Mild
Moderate or Medium
Very Spicy
Add any coments: Bread preferences? Do you have any favorite recipes that I can prepare for you?
*Which of the following do you prefer when reheating your food?
You prefer Stove Top (mark if you like)
You prefer Oven (Mark if you like)
Microwave (Mark if you like)
*Explain more on how you prefer reheating your food?
Do you have a barbecue and want meals prepared for cooking on it? If I was at your place what kind of Stove type Gas/Electric do you have?
Gas
Electric
Electric Glass Top
One Oven
Two Ovens
Microwave
Do you have a wok and want meals prepared for cooking in it? Do you only want Fresh meals or is frozen okay? Do you like International cuisine? - Mexican/Curries/Italian, etc.
What is your favorite Restaurants?
The more information you give the better I can serve you. Additional Comments:

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