Food Questionnaire

Please download, print and fill out this form -- return it to us by email or snail mail before you arrive.

Name:___________________________________

Allergies or intolerances to any foods: ______________________________________________________

 

Foods I dislike (please be honest and complete I hate cooking a food only to find out someone dislikes a prominent ingredient): _____________________________________________________________

My favorite dinner is: _______________________________________________________

 

My favorite lunch is: ________________________________________________________

 

My favorite breakfast is: _____________________________________________________

 

Favorite canned beverages: __________________________________________________

 

Favorite cold liquid made from powder (e.g. iced tea, lemonade, Gatorade...)_______

 

Favorite hot liquid, other than coffee (e.g. cocoa, bouillon, special tea...)___________

Favorite juice (e.g. pineapple, orange, tomato...) ________________________________

Do you drink milk? ________How much per day?_____ glasses. What type (skim, 2% etc.)_________________________________________________________________

What are your favorite snack foods (e.g. crackers, candy etc. )____________________