Food Preference Consent Form
Please provide your food preferences, dietary needs, and consent for us to use this information for meal planning or catering purposes.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please select your primary dietary preference.
*
No Preference
Vegetarian
Vegan
Pescatarian
Halal
Kosher
Gluten-Free
Other
Do you have any food allergies?
Peanuts
Tree Nuts
Dairy
Eggs
Shellfish
Soy
Wheat/Gluten
Other
Please list any other dietary restrictions or foods you avoid.
How often do you require meal accommodations?
Every Meal
Only at Events
Occasionally
Other
Which cuisines do you prefer? (Select all that apply)
American
Italian
Mexican
Asian
Mediterranean
Middle Eastern
Other
Are there any foods you strongly dislike?
Emergency Contact Name (in case of severe allergy reaction)
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
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