Section 1 of 1
Client Assessment
Name
Name
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Your Spicy Food Scale
Your Spicy Food Scale
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Mild
Medium
Hot
Extremely Hot
Other:
Add option
…
Answer key
(0 points)
Loading...
May I cook with wine/liquors?
May I cook with wine/liquors?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
Other:
Add option
…
Answer key
(0 points)
Loading...
Which cuisines do you enjoy?
Which cuisines do you enjoy?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Mexican/Central/South American
Italian
Thai
Chinese
Japanese
Indian
Persian/Middle Eastern
Spanish
Comfort Food/Southern/American
Greek
French
Other:
Add option
…
Answer key
(0 points)
Loading...
Leafy Greens
Leafy Greens
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Arugula
Baby Spinach
Mixed Greens
Romaine
Iceberg
Baby Kale
Rows
1.
Arugula
2.
Baby Spinach
3.
Mixed Greens
4.
Romaine
5.
Iceberg
6.
Baby Kale
7.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Cruciferous Vegetables
Cruciferous Vegetables
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Broccoli
Cauliflower
Brussels Sprouts
Kale
Red Cabbage
Green Cabbage
Radish
Collard greens
Bok Choy
Rows
1.
Broccoli
2.
Cauliflower
3.
Brussels Sprouts
4.
Kale
5.
Red Cabbage
6.
Green Cabbage
7.
Radish
8.
Collard greens
9.
Bok Choy
10.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Starchy & Root Vegetables
Starchy & Root Vegetables
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Sweet Potato
Butternut/Acorn/Spaghetti/Winter Squash
Potatoes
Plantains
Beets
Carrots
Parsnips
Celery Root
Turnips/Rutabagas
Rows
1.
Sweet Potato
2.
Butternut/Acorn/Spaghetti/Winter Squash
3.
Potatoes
4.
Plantains
5.
Beets
6.
Carrots
7.
Parsnips
8.
Celery Root
9.
Turnips/Rutabagas
10.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Other vegetables
Other vegetables
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Tomato
Bell Peppers
Hot Peppers
Eggplant
Celery
Corn
Green Beans
Cucumbers
Asparagus
Zucchini/Yellow Squash
Fennel
Swiss Chard
Mushrooms
Cilantro
Ginger root
Rows
1.
Tomato
2.
Bell Peppers
3.
Hot Peppers
4.
Eggplant
5.
Celery
6.
Corn
7.
Green Beans
8.
Cucumbers
9.
Asparagus
10.
Zucchini/Yellow Squash
11.
Fennel
12.
Swiss Chard
13.
Mushrooms
14.
Cilantro
15.
Ginger root
16.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Fruit: Please list any likes/dislikes:
Fruit: Please list any likes/dislikes:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Nuts and Seeds
Nuts and Seeds
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Peanuts
Coconut & Coconut Milk
Almonds
Pecans
Cashews
Walnuts
Pine nuts
Macadamia nuts
Pumpkin seeds
Sesame seeds
Flax seeds
Rows
1.
Peanuts
2.
Coconut & Coconut Milk
3.
Almonds
4.
Pecans
5.
Cashews
6.
Walnuts
7.
Pine nuts
8.
Macadamia nuts
9.
Pumpkin seeds
10.
Sesame seeds
11.
Flax seeds
12.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Beans, Grains, Pasta
Beans, Grains, Pasta
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Beans (black, kidney, pinto, etc.)
Chickpeas
Lentils
White Rice
Brown Rice
Wild Rice
Sushi rice
Risotto
Quinoa
Polenta
Quinoa Pasta
Rice Pasta
Rows
1.
Beans (black, kidney, pinto, etc.)
2.
Chickpeas
3.
Lentils
4.
White Rice
5.
Brown Rice
6.
Wild Rice
7.
Sushi rice
8.
Risotto
9.
Quinoa
10.
Polenta
11.
Quinoa Pasta
12.
Rice Pasta
13.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Seafood and Fish
Seafood and Fish
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Salmon
Halibut
Cod
Trout
Sea Bass
Tuna
Scallops
Mussels/Clams
Shrimp
Lobster
Calamari
Crab
Rows
1.
Salmon
2.
Halibut
3.
Cod
4.
Trout
5.
Sea Bass
6.
Tuna
7.
Scallops
8.
Mussels/Clams
9.
Shrimp
10.
Lobster
11.
Calamari
12.
Crab
13.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Meat and Poultry
Meat and Poultry
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Beef
Chicken
Turkey
Pork
Duck
Bacon
Uncured Bacon
Cured Meats/Sausages
Rows
1.
Beef
2.
Chicken
3.
Turkey
4.
Pork
5.
Duck
6.
Bacon
7.
Uncured Bacon
8.
Cured Meats/Sausages
9.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
How do you prefer your steak cooked?
How do you prefer your steak cooked?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Rare
Medium-rare
Medium
Medium-well
Well-done
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Do you mind bone-in meats, (t-bone steaks, pork chops, chicken thighs/drumsticks, lamb chops)
Do you mind bone-in meats, (t-bone steaks, pork chops, chicken thighs/drumsticks, lamb chops)
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Other:
Add option
…
Answer key
(0 points)
Loading...
Dairy/Cheese
Dairy/Cheese
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Cow's milk
Goat's milk
Sheep's milk
Butter
Yogurt
Sour Cream
Parmesan
Cheddar
Monterrey Jack
Feta
Brie
Blue cheese
Rows
1.
Cow's milk
2.
Goat's milk
3.
Sheep's milk
4.
Butter
5.
Yogurt
6.
Sour Cream
7.
Parmesan
8.
Cheddar
9.
Monterrey Jack
10.
Feta
11.
Brie
12.
Blue cheese
13.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Do you enjoy fermented/pickled foods?
Do you enjoy fermented/pickled foods?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Sauerkraut
Kimchi
Kombucha
Pickled vegetables
Balsamic Vinegar
Rice Vinegar
Wine/Sherry/Champagne Vinegars
Apple Cider Vinegar
Malt Vinegar
Rows
1.
Sauerkraut
2.
Kimchi
3.
Kombucha
4.
Pickled vegetables
5.
Balsamic Vinegar
6.
Rice Vinegar
7.
Wine/Sherry/Champagne Vinegars
8.
Apple Cider Vinegar
9.
Malt Vinegar
10.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Any additional requests/comments on foods listed or not listed above:
Any additional requests/comments on foods listed or not listed above:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
What types of snacks do you prefer?
What types of snacks do you prefer?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Do you enjoy these types of dishes?
Do you enjoy these types of dishes?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Yes
No
Lasagna/Baked Pasta Dishes
Shepherd's Pie
Curry
Stews
Soups
Stir-fries
Tacos
Enchiladas
Salads
Pot Pies
Rice/Noodle Bowls
Rows
1.
Lasagna/Baked Pasta Dishes
2.
Shepherd's Pie
3.
Curry
4.
Stews
5.
Soups
6.
Stir-fries
7.
Tacos
8.
Enchiladas
9.
Salads
10.
Pot Pies
11.
Rice/Noodle Bowls
12.
Add row
Columns
Yes
No
Add column
…
Answer key
(0 points)
Loading...
Dishes your previous chef made that you enjoyed:
Dishes your previous chef made that you enjoyed:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
What is your idea of a healthy meal?
What is your idea of a healthy meal?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Sweets and desserts: what are your preferences?
Sweets and desserts: what are your preferences?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Which restaurants do you frequent?
Which restaurants do you frequent?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Please list any other concerns or requests you may want me to know about, including meal presentation, clean-up, what can and cannot be used, information about the home, etc.
Please list any other concerns or requests you may want me to know about, including meal presentation, clean-up, what can and cannot be used, information about the home, etc.
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
New
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Link to Sheets
Message for respondents
This form is no longer accepting responses
Summary
Question
Individual
Insights
Total points distribution
Loading...
Settings
Responses
Manage how responses are collected and protected
Presentation
Manage how the form and responses are presented
Defaults
Form defaults
Settings applied to this form and new forms
Question defaults
Settings applied to all new questions