212.227.8610
info@foodmattersnyc.com
Food Preferences Form
First Name
Last Name
Address
Address L2
City
State
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
AE
AA
AP
Zip Code
Home Phone
Other Phone
Mobile Phone
Email
Service
Meal Prep
Dinner Party
Cooking Instruction
Number of People
Date of Requested Service
TYPES OF CUISINES
Often
Sometimes
Never
American
Chinese
Cuban
French
Greek
Indian
Italian
Japanese
Latin American
Mediterranean
Mexican
Middle Eastern
Spanish
HOW DO YOU LIKE TO EAT?
Often
Sometimes
Never
Gluten Free
High Protein
Kosher
Lactose Free
Low-Carb
Low-Fat
Low-Salt
South Beach
Spicy Foods
Vegan
Vegetarian
PROTEIN SOURCES
Often
Sometimes
Never
Eggs
Beef
Buffalo
Lamb
Pork
Chicken
Fish
Shellfish
STARCHES
Often
Sometimes
Never
Corn
Millet
Oats
Nuts
Teff
Polenta
Sweet Potato
Quinoa
Amaranth
Brown Rice
Wild Rice
Whole Grain Pasta
VEGETABLES & FRUITS
Often
Sometimes
Never
Artichokes
Asparagus
Beets
Broccoli
Broccoli Rape
Berries
Carrots
Cauliflower
Celery
Citrus
Coconut
Cucumbers
Eggplant
Fennel
Garlic
Ginger
Leafy Greens
Melon
Mushrooms
Olives
Onions
Root Vegetables
Winter Squashes
Summer Squashes
Tomatoes
Beans
Often
Sometimes
Never
Adzuki
Black
Black Eyed Pea
Cannellini
Garbanzo
Kidney
Lentils
Mung
Navy
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