Food Questionnaire
Please complete our food questionnaire to get started with a customized meal delivery service.
GENERAL INFORMATION
Client Name #1
*
First Name
Last Name
*
Phone Number
Email Address
*
Birthday
Other Information
Client Name #2
First Name
Last Name
Birthday
Other Information
Phone Number
Email Address
Other Adults - Names & Birthdays
Children - Names & Ages
Pets - Names & Types
Delivery Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Notes for Delivery Driver (ie gate code, etc)
Preferred Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Email Address
*
example@example.com
How did you hear about Delishes Dishes?
*
Google Search
Referral
Advertisement
Instagram
Facebook
LinkedIn
Other
If you Googled us, what were the keywords you used?
Favorite Restaurants
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SERVICE DETAILS
How many meals would you like for the week?
3 Days A Week
4 Days A Week
5 Days A Week
6 Days A Week
7 Days A Week
Meals you would like prepared:
Breakfast
Lunch
Dinner
Snack
Service Frequency:
Daily
Weekly
Every Other Week
Monthly
Sides with Entrée:
1 with each entrée
2 with each entrée
Number of servings of each meal by day (Enter number of servings):
Rows
Sun
Mon
Tues
Wed
Thurs
Fri
Sat
Breakfast
Lunch
Dinner
Snack
Grocery Preferences:
Organic
Conventional
Farmer's Market
Other
Comments - Grocery Preferences:
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FOOD PREPARATION & STORAGE
How do you like to reheat/serve your food?
I prefer to only have to use a microwave.
Never use a microwave (Stove top or oven only)
No Preference
What type of containers would you like used?
Reusable Plastic (BPA free)
Disposable (BPA free)
Glass only* (Subject to additional cost)
Comments - Container Preferences:
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FOOD PREFERENCES
Here is your opportunity to let us know what you prefer in your customized menu. Please select "YES" to identify preferences and "NO" to identify any foods that you don’t like and never wish to see. Please feel free to add comments.
Special Requirements
Rows
Yes
No
Comments
Low Fat
Low Carb
Low Sodium
Low Inflammation
Ketogenic
Paleo
Vegetarian
Vegan
Seasonal
Pre/Post Surgery/Chemo
Professional Athlete
Medically Prescribed
Additional Requests - Special Requirements
Food Sensitivities or Allergies
None
Dairy
Peanuts
Tree Nuts
Shellfish
Soy
Corn
Wheat/Gluten
Please don't cook with:
Cuisines You Enjoy
Latin American
Italian
French
Chinese
Japanese
Thai
Middle Eastern
Indian
Spanish
Cajun
Mediterranean
Caribbean
Southern
Mexican
Greek
I also enjoy:
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PROTEINS & DAIRY
Please select "YES" to identify preferences and "NO" to identify any foods that you don’t like and never wish to see. Please feel free to add comments.
Poultry
Rows
Yes
No
Comments
Chicken (breasts/thighs/ground/white/dark)
Turkey(breasts/smoked/ground/scalloped)
Duck
Cornish Game Hen
Cooking Methods - Poultry
Rows
Yes
No
Comments
Grilled
Fried
Pan Seared
Poached
Baked
Roasted
OtherPlease specify in comments.
Meats
Rows
Yes
No
Comments
Beef(steak/roasts/ground/round)Please enter how steak should be cooked in the comments.
Pork(chops/roasts/ribs/bacon/ham/ground)
Lamb(chops/stew/ground/roasts)
Bison (steaks/ground)
Meatloaf
Meat and vegetable/pasta casseroles
Wild game(ostrich, venison, etc)
Cooking Methods - Meats
Rows
Yes
No
Comments
Grilled
Pan Seared
Baked
Roasted
OtherPlease specify in comments.
Shellfish
Rows
Yes
No
Comments
Shrimp
Scallops
Crab
Lobster
Oysters(Raw/Cooked)
Clams (Raw/Cooked)
Fish
Rows
Yes
No
Comments
Arctic Char
Anchovies
Branzino
Catfish
Chilean Seabass
Cod
Flounder
Halibut
Monkfish
Orange Roughy
Sardines
Sole
Swordfish
Snapper
Salmon
Tilapia
Tuna
Trout
OtherPlease specify in comments.
Comments - Shellfish/Fish
Other
Rows
Yes
No
Comments
Tofu
Tempeh
Eggs (Yolks only/whites only)
Beans(garbanzo/pinto/black/lentils/navy/butter beans/fava)
OtherPlease specify in comments.
Comments - Other
Milk and Milk Products
Rows
Yes
No
Comments
Milk(skim, 1%, 2%, whole)
Cottage cheese
Yogurt
Sour Cream
Half and Half
Plant Based MilksPlease specify in comments.
Comments - Milk and Milk Products
Favorite Cheeses
Please enter preferred cheeses. If none, enter N/A.
Soups
Rows
Yes
No
Comments
Creamed
Cold (ie Gazpacho)
Chunky
Clear/Broths
With meat/poultry/seafood
Soups as a main dish
Vegetarian/Vegan
OtherPlease specify in comments.
Comments - Soups
Salads
Rows
Yes
No
Comments
Fresh Greens(Romaine/Red leaf/ Bibb/ Arugula/ Dandelion Greens /Spring Mix/ Spinach)
Fresh Greens(Other - Please specify in comments)
Fruit
Rice
Pasta
Bean
Salads as a main dish
Other
Salad Dressings
Rows
Yes
No
Comments
Vinaigrette with Herbs
French
Oil/Vinegar
Balsamic
Carrot Ginger
Poppy Seed
OtherPlease specify in comments.
Comments - Salads & Salad Dressings
Breads
Rows
Yes
No
Comments
Whole Wheat
White
Rolls(white/wheat/sourdough)
Biscuits
Cornbread
Muffins
Pancakes
Waffles
Tortillas
Gluten Free
Fruits and Vegetables (List is only partial. Please add items in comments.)
Rows
Yes
No
Comments
Green(peas/green beans/spinach/asparagus/peppers/cabbage/kale/celery/mustard greens/kiwi/granny smith apples)
Yellow/Orange (corn/wax beans/squash/peppers/sweet potatoes/yams/ oranges/lemons/ cantaloupe )
Red (pimento/red cabbage/beets/tomatoes/ bell peppers/strawberries/raspberries)
White (cauliflower/potatoes/parsnips/water chestnuts/bean sprouts/onions/mushrooms/leeks)
Purple: (eggplant/ cabbage/ blueberries/blackberries)
Other Favorites
Fruits and Vegetables - List what not to use
Comments - Fruits and Vegetables
Grains
Rows
Yes
No
Comments
Rice(White/Brown/Forbidden Black/Wild)
Couscous
Quinoa
Bulgur
Spelt
Teff
Amaranth
Millet
Other
Comments - Grains
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SEASONINGS & CONDIMENTS
Seasonings
Rows
Yes
No
Comments
Anise
Basil Celery Seed
Cumin
Cilantro
Chili Powder
Curry
Dill
Fennel Seeds
Garlic
Ginger
Mint
Oregano
Paprika
Parsley
Pepper
Rosemary
Sage
Thyme
Tarragon
Salt
OtherPlease specify in comments.
Seasonings to AvoidPlease specify in comments.
Comments - Seasonings
Fats/Oils
Rows
Yes
No
Comments
Butter
Ghee
Avocado Oil
Coconut Oil
Canola Oil
Olive Oil
Sunflower Oil
Grape-seed Oil
OtherPlease specify in comments.
Comments - Fats/Oils
How spicy do you like your food?
Keep the chilies away!
Mild
Medium
The hotter the better
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FINAL NOTES
Add Ons
Rows
Yes
No
Comments
Child friendly options along with my meals
Snacks prepared to have during the day
Any other information that will help us to provide a customized Delishes Dishes Experience for you? IE Favorite restaurants?
Submit
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