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Allergies and Requirements Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
Do you have any food allergies?
Choose all that apply
Gluten
Dairy
Nuts
Shellfish
Soy
None
2
On a scale of 1 to 10, how do you rate your spice tolerance?
Rate from 1 (low) to 10 (high)
3
Please describe any dietary restrictions or preferences you have
Write your response here
4
Are you vegetarian?
Choose one
Yes
No
5
Do you avoid any specific ingredients?
If yes, please specify
6
Do you have any religious dietary restrictions?
If yes, please specify
7
How often do you enjoy seafood?
Choose one
Regularly
Occasionally
Rarely
Never
8
Do you have any preferences for organic or locally sourced ingredients?
Choose one
Organic
Locally Sourced
No Preference
9
Would you like options for gluten-free dishes?
Choose one
Yes
No
10
Please indicate any specific fruits or vegetables you dislike
If none, write 'None'
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