To begin with, How May I Help You?
Are you ill or recovering from an illness?
Do you need to follow a special diet or meal plan?
Would you like to eat differently from how yo do now?
What are the food goals for you and your family?
Here is your opportunity to let me know what you prefer in your customized menu. Please check preferences and add comments.
Circle any foods that you don’t like and never wish to see.
- __ Beef (steak/roasts/ground round)
- __ Pork (chops/roasts/ribs/bacon/ham/ground)
- __ Veal (stew/ground/scallops)
- __ Lamb (chops/stew/ground/roasts)
- __ Meat and vegetable/pasta casseroles
- Other (rabbit, goat, buffalo; offal such as sweetbreads or liver)______________
- __ Chicken (breasts/thighs/ground/etc.)
- __ Turkey (breasts/smoked/ground/scalloped/etc.)
- __ Chicken or turkey and vegetable/pasta casseroles
- Other (duck, goose, pheasant, quail, squab)
- __ Fish (salmon, halibut, etc.)
- __ Shrimp
- __ Scallops
- __ Crab
- __ Lobster
- __ Tinned Fish/Shellfish (tuna, crab, anchovies; canned, in oil or water?)
- Exotics (oysters, eel)
- _ Fresh Green (choice of greens/lettuces, such as Romaine, red leaf, bibb, mixture, spinach, etc.)
- __ Fruit
- __ Rice
- __ Pasta
- __ Salads as a main dish?
- __ Mayonnaise
- __ Ranch
- __ Vinaigrette
- __ French
- __ Oil/vinegar
- __ Red wine/vinegar
- __ Thousand Island
- __ Other (identify)
- __ Creamed
- __ Hot
- __ Cold
- __ Chunky
- __ Clear
- __ With meat/poultry?
- __ Soups as a main dish?
- __ 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)
- __ Rice
- __ Couscous
- __ Quinoa
- __ Wheat/granola
- __ Corn
- __ Other (identify)
- __ Wheat
- __ White
- __ Rolls (white or wheat, sourdough, etc.)
- __ Biscuits
- __ Cornbread
- __ Muffins
- __ Pancakes
- __ Waffles
- __ Tortillas
- __ Oregano, sage, rosemary, tarragon, fennel, cumin, cilantro, paprika, parsley, celery, chili powder, garlic
- __ Pepper—white, black or red
- __ Salt—Sea or Kosher
- __ Butter
- __ Margarine
- __ Canola Oil
- __ Corn Oil
- __ Olive Oil
- __ Vegetable Oil
- __ Sunflower Oil
- __ Lard
- __ Shortening
MILK AND MILK PRODUCTS:
- __ Cheeses (Parmesan, cheddar, Swiss, muenster, fontina, etc.)
- __ Milk (skim, 1%, 2%, whole)
- __ Cottage cheese
- __ Yogurt
- __ Sour cream
- __ Half and half
- __ Whole
- __ Yolks only
- __ Whites only
- __ Eggbeaters substitute
- __ Tofu
- __ Soy-based meatless products
- __ Nuts (pecans, peanuts, walnuts, almonds, cashews, Brazil, etc.)
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
Do you have any favorite recipes that I can prepare for you?
Rate your preference for organic foods-
Do you have a CSA box you wish me to work with?
If no, are you interested in signing up for one?