Menu Nutritional Audit Form
Use this form to assess and record the nutritional quality of menu offerings for food service establishments.
Establishment Name
*
Location/Branch
*
Date of Audit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Name
*
First Name
Last Name
Menu Type
*
Please Select
Breakfast
Lunch
Dinner
Snacks
Beverages
Other
List the menu items being audited
*
Nutritional Assessment Table
*
Rows
Calories (kcal)
Total Fat (g)
Sodium (mg)
Added Sugar (g)
Fiber (g)
Protein (g)
Menu Item 1
Menu Item 2
Menu Item 3
Menu Item 4
Menu Item 5
Does the menu clearly display nutritional information for each item?
*
Yes
No
Partially
Overall Nutritional Balance Rating
*
1
2
3
4
5
Compliance with Nutritional Standards
Low-calorie options available
Low-sodium options available
Vegetarian/Vegan options available
Whole grain options available
Allergen information provided
Other
Comments or Recommendations
Submit Audit
Should be Empty: