Christine's Clean Eats: Private Cooking Services Intake Form
Please answer the following questions to the best of your ability. In order to best serve you, it's helpful to have as much appropriate background information as possible. Once you've completed this form, we can schedule your personal consultation and jump right in!
Name:
Your answer
DOB:
Your answer
Email:
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Phone:
Your answer
Address:
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Preferred Method of Contact:
Do you currently follow (or wish to try) a specific dietary protocol?
Do you count macros and/or calories as part of your current dietary regime?
Do you have any food allergies or sensitivities? If so, please list below:
Your answer
Do you have any foods that you really don't like (e.g., seafood, onions, etc.)?
Your answer
Do you have any favorite foods?
Your answer
Do you have a preference for organic versus non-organic food?
How many people in your household are you currently seeking cooking services for?
Do you prefer individually packaged meals or large containers containing multiple portions (i.e., family style)?
Would you prefer home delivery or pickup?
Do you have a specific goal in mind in relation to seeking private cooking services (e.g., wanting to eat healthier, wanting to free up more time, etc.)?
Your answer
Anything else I should know?
Your answer
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