Prepared Meals Questionnaire



Here is your opportunity to let me know what you prefer in your customized menu. Please check preferences and add comments. Place a check mark next to any foods that you don’t like and never wish to see.  Email this form to us upon completetion


MEATS:
__ Beef (steak/roasts/ground round)
__ Pork (chops/roasts/ribs/bacon/ham/ground)
__ Veal (stew/ground/scallops)
__ Lamb (chops/stew/ground/roasts)
__ Meatloaf
__ Meat and vegetable/pasta casseroles

Comments:

POULTRY:
__ Chicken (breasts/thighs/ground/etc.)
__ Turkey (breasts/smoked/ground/scalloped/etc.)
__ Chicken or turkey meatloaf
__ Chicken or turkey and vegetable/pasta casseroles

Comments:

FISH/SHELLFISH:
__ Fish (bass, sole, cod, trout, salmon)
__ Shrimp
__ Scallops
__ Crab
__ Lobster
__ Tuna (canned, in oil or water?)

Comments:

SALADS:
__ Fresh Green (choice of greens/lettuces, such as Romaine, red leaf, bibb, mixture, spinach, etc.)
__ Fruit
__ Rice
__ Pasta
__ Jello
__ Salads as a main dish?

Comments:

SALAD DRESSINGS:
__ Mayonnaise
__ Ranch
__ Vinaigrette
__ French
__ Oil/vinegar
__ Red wine/vinegar
__ Thousand Island
__ other (identify)

Comments:

SOUPS:
__ Creamed (name type) ______________________________________
__ Hot
__ Cold
__ Chunky
__ Clear
__ With meat/poultry?
__ Soups as a main dish?

Comments

VEGETABLES:
__ Green (peas, green beans, spinach, asparagus, peppers, cabbage, pea pods, celery, mustard greens)
__ Yellow (corn, wax beans, squash, peppers)
__ Red (pimento, red cabbage, beets, tomatoes, peppers, sweet potatoes/yams)
__ White (cauliflower, potatoes, parsnips, water chestnuts, bean sprouts, onions, mushrooms, leeks)
__ Beans (black, ranch-style, pinto, kidney, lima, white, pink)

Comments:

GRAINS:
__ Rice
__ Couscous
__ Quinoa
__ Wheat/granola
__ Corn
__ Other (identify)

Comments:


BREADS:
__ Wheat
__ White
__ Rolls (white or wheat, sour dough, etc.)
__ Biscuits
__ Cornbread
__ Muffins
__ Pancakes
__ Waffles
__ Tortillas



Comments:


SEASONINGS:
__ Oregano, sage, rosemary, tarragon, fennel, cumin, cilantro, paprika, parsley, celery, chili powder
__ Fresh garlic, parsley
__ Pepper—white, black or red
__ Salt—Kosher


Comments:


FATS/OILS:
__ Butter
__ Margarine
__ Canola Oil
__ Corn Oil
__ Olive Oil
__ Vegetable Oil
__ Sunflower Oil
__ Lard
__ Shortening


Comments:


MILK AND MILK PRODUCTS:
__ Cheeses (parmesan, cheddar, swiss, muenster, fontina, etc.)
__ Milk (skim, 1%, 2%, whole)
__ Cottage cheese
__ Yogurt
__ Sour cream
__ Half and half



Comments:


EGGS:
__ Whole
__ Yolks only
__ Whites only
__ Eggbeaters substitute

Comments:

OTHER:
__ Tofu
__ Soy-based meatless products
__ Nuts (pecans, peanuts, walnuts, almonds, cashews, Brazil, etc.)

Comments:



List any vegetables or fruits you don’t ever want to see
List any other food dislikes
List any known food allergies
Rate your preference for spicy foods - bland/mild/moderate/very
Bread preferences
Do you have any favorite recipes that we can prepare for you?
Do you have a grill and want meals prepared for cooking on it?
Do you have a wok and want meals prepared for cooking in it?
International cuisine? - Mexican/Curries/Italian, etc.




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