Your Natural Chef Questionnaire
*Required Question(s)
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Name
*
Email Address
*
Phone
*
Address
Foods that interest you most (choose as many as you like)
Italian
Japanese
Thai
Chinese
Seafood
Vegan
Gluten Free
Raw/Living Foods
Vietnamese
Mexican
Tofu/Tempeh
Southwest
Northwest
American Comfort Foods
French
Indian
Other
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Do you have any food intolerances or allergies for you or your family members?
None
Wheat
Gluten
Dairy
Corn
Sugar
Cocoa/Chocolate
Onions
Peppers
Tomatoes
Other
What is the level of severity regarding your food intolerances or allergies?
Mild
Medium
Severe
What are foods you generally avoid?
Health/Fitness Goals
Weight Loss
Preventative (for cholesterol, heart problems, etc.)
Diet in conjunction with medical treatment (please specify in detail)
Working with doctor's or nutritionist's guidelines
Other
Do you have a specific diet recommended for you?
Are you an active athlete in need of a meal plan to support your training?
Yes
No
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What type of meal plan interests you most?
Several main meals with sides
Lunches and healty snacks
Main meals with sides and lunch options
Breakfast options
Desserts
Other
Would you prefer to?
Have meals ready to simply heat up in under 15 minutes
Have meals ready to finsih cooking in under 20 minutes
Have a combination of meals that are ready to quickly cook for fresh meals
Not Sure
Are you interested in a grocery tour and personalized pantry stocking?
Yes
No
Do you have space in a refrigerator or freezer for prepared food?
Lots
Some
Very Little
None
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Please select your cooking method(s)
Gas Oven
Electric Oven
Convection Oven
Microwave
Shopping preference
All organic
Mix of organic and conventional
No preference
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Delivery preference
Home
Office
Pick-up
What are some foods you would love to try that you wouldn't have cooked or bought yourself?
Other things you would like to share with me
Add me to your email list
ALIVE AND WELL IN BEAUTIFUL PORTLAND, OR *
503.828.7662
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I
NFO@YOURNATURALCHEF.COM
