Organic Chef Intake Form First Name *Last Name *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodePhone *Email Address *Number of people *Special Diets *Are you gluten free or do you prefer sprouted wheat? *Medical Conditions *Food allergies *Likes/DislikesFavorite meats *Dark MeatWhite MeatVegetarianWhich do you prefer when eating chicken or turkey?I like any/ all meats *YesNoMeat I don’t likeI like all seafood *YesNoSeafood I don’t likeI like all vegetables *YesNoVegetables I don’t likeI like all starches/grains *YesNoStarches/grains I don’t likeI like all Spices/Herbs *YesNoSpices/Herbs I don’t likeI eat organic dairy *YesNoI like butter *YesNoI like yogurt *YesNoI like Earthbalance *YesNoWine/Liquor *YesNoMay I cook with wine and liquor?Please check your favorite types of cuisine *FrenchItalianGreekThaiIndianJapaneseChineseKoreanAmerican SouthernAmericanOtherSpice Scale *BlandMildMediumHotWhere do your tastes fall on the spicy scale?Salt Preference (I use Himilayan Sea salt) *No SaltLow SaltModerate SaltI like salt!Where do your tastes fall on the salty scale?Red meat *RareMedium rareMediumWell doneVegetarianHow do you like your red meat cooked?FrozenYesNoIf you would prefer entrees that can freeze, do you have adequate freezer space for frozen entrees?Organic Chef Service Frequency *Twice a weekOnce a weekOnce a monthOTHER Send MessagePlease do not fill in this field.
