CLIENT INFORMATION Address Email Primary phone Emergency Contact Secondary phone Emergency Contact Phone HOUSEHOLD INFORMATION Others I will be cooking for: Relationship Birthday Relationship Birthday Relationship Birthday Relationship Birthday Relationship Birthday Relationship Birthday Pets: Cat or Dog? Inside or Outside? Can have treats? Cat or Dog? Inside or Outside? Can have treats? Cat or Dog? Inside or Outside? Can have treats? Who will be home while I am cooking, if anyone? Where will you be while I am cooking?
EATING HABITS Why would you like to hire a personal chef? Do you know how many meals you would like prepared each week? How many times per week do you do the following for dinners? Cook at home with ingredients I ve purchased for a specific recipe Cook at home with ingredients I have on hand, making it up as I go along Eat leftovers Eat snack foods or other things I can find in my pantry that I don t have to cook Dine out at a restaurant Eat fast food Order take out or delivery Eat prepared foods from the grocery store or other food retailer Other: Do you have any favorite dishes in general you would like me to make or specific recipes you would like me to use on occasion? What is your favorite local restaurant, and why? Please indicate your preferences as related to trying new foods: Prefer to eat what I know I like Love to try new foods 1 2 3 4 5 What is your favorite food memory?
If you have children, do they generally eat the same meals as you do? What are some concerns you have, if any, about your current eating habits? HEALTH INFORMATION If you currently work with a doctor, dietician, or nutritionist and would like me to consult them when planning your menu, please provide their name and contact information. Please list any health conditions which influence your diet (high blood pressure, high cholesterol, diabetes, heart conditions), allergies/intolerances (lactose, nuts, latex, other foods), dietary restrictions (low-sodium, low-fat, vegetarian, vegan, paleo, gluten-free, etc), or special diets (Weight Watchers, Atkins, etc) which you d like to share with me.
GENERAL PREFERENCES Please indicate your preferences for ORGANIC food as related to cost: Always prefer the lowest-cost option Always prefer organic, even if more expensive 1 2 3 4 5 Please provide an explanation if you have a request for specific foods to always be ORGANIC or if there is another factor to consider when determining whether or not to buy organic. Please indicate your preferences for LOCAL food as related to cost: Always prefer the lowest-cost option Always prefer local, even if more expensive 1 2 3 4 5 Please provide an explanation if you have a request for specific foods to always be LOCAL or if there is another factor to consider when determining whether or not to buy local. Do you have a grocery budget I should adhere to? If so, please indicate roughly how much you d like to spend each week.
Do you have a preference as to where I shop for your groceries (check all that apply)? Farmers markets Whole Foods Market Central Market Kroger Tom Thumb Sprouts Fiesta Other grocery store Which international cuisines do you enjoy (circle all that apply)? Chinese French Indian Italian Japanese Latin Mexican Spanish Thai Which level of spice do you and your family prefer? None Mild Medium Hot Very Hot May I cook with alcohol (wine, beer, spirits) for flavor? Do you enjoy vegetarian entrees, and if so, how often? Do you enjoy soups as a main entrée, and if so, how often? Do you enjoy salads as a main entrée, and if so, how often?
INGREDIENT PREFERENCES See each category below. Please cross out any items that you dislike or do NOT want in any dishes. Please feel free to add any items that may be missing and make any notes indicating items you d like to try, that you love, etc. Don t worry if some items are unfamiliar; we can talk about introducing new foods to your diet if you d like to know more about any ingredients. Example: NUTS Almonds Cashews Hazelnuts Macadamia Peanuts Pecans Pine Nuts Pistachios Walnuts I love Brazil nuts! want to try MEAT Beef Pork Veal Lamb Bison Venison Rabbit POULTRY Chicken: white meat dark meat bone-in boneless skin-on skinless Turkey Duck Quail Game Hen FISH Arctic Char Bass Catfish Cod Flounder Grouper Halibut Sablefish Salmon Snapper Sole Swordfish Tilapia Trout Tuna SHELLFISH Clams Crab Lobster Mussels Oysters Scallops Shrimp Squid MEAT SUBSTITUTES Seitan Tempeh Tofu VEGETABLES Acorn Squash Artichokes Arugula Asparagus Beets Bell Peppers Broccoli Brussels Sprouts Butternut Squash Cabbage Carrots Cauliflower Celery Root Chard Chili Peppers Collard Greens Corn Cucumber Delicata Squash Eggplant Endive Fennel Garlic Green Beans Jicama Kale Leeks Lettuce Mushrooms Okra Olives Onion
As a reminder, please cross out any items that you dislike or do NOT want in any dishes. Please feel free to add any items that may be missing and make any notes indicating items you d like to try, that you love, etc. Don t worry if some items are unfamiliar; we can talk about introducing new foods to your diet if you d like to know more about any ingredients. VEGETABLES (continued) Parsnips Peas Potatoes Pumpkin Radishes Rutabaga Shallots Spaghetti Squash Spinach Sunchokes Sweet potatoes Tomatoes Turnips Yellow Squash Zucchini NON-CITRUS FRUITS Apples Apricot Avocado Bananas Blackberries Blueberries Cantaloupe Cherries Cranberries Figs Grapes Honeydew Kiwi Mango Nectarines Papaya Peaches Pears Pineapple Plums Pomegranate Raspberries Strawberries Watermelon CITRUS Blood Orange Grapefruit Key Lime Kumquats Lemon Lime Meyer Lemon Orange Tangerine BEANS Black Black-eyed Peas Cannellini Chickpeas Fava Great Northern Kidney Lentils Lima Mung Pinto Small Red GRAINS/STARCH Barley Bran Brown Rice Bulgur Wheat Cornmeal Couscous Farro Millet Oats Orzo Pasta Polenta Quinoa Risotto Wheat Berries White Rice NUTS & SEEDS Almonds Cashews Hazelnuts Macadamia Peanuts Pecans Pine Nuts Pistachios Walnuts Pumpkin Seeds Sunflower Seeds HERBS Basil Chervil Chives Cilantro Dill Marjoram Mint Oregano Parsley Rosemary Sage Tarragon Thyme
As a reminder, please cross out any items that you dislike or do NOT want in any dishes. Please feel free to add any items that may be missing and make any notes indicating items you d like to try, that you love, etc. Don t worry if some items are unfamiliar; we can talk about introducing new foods to your diet if you d like to know more about any ingredients. SPICES Cardamom Cayenne Chipotle Cinnamon Coriander Crushed Red Pepper Cumin Curry Fennel Ginger Nutmeg Paprika Saffron Turmeric CHEESES Blue Brie Cheddar Cottage Cream Feta Fontina Goat Gorgonzola Gruyere Manchego Mascarpone Mozzarella Parmesan Ricotta Swiss DAIRY Butter Crème Fraiche Eggs Egg Substitutes Half & Half Heavy Cream Milk Milk Substitutes (almond, soy, rice) Sour Cream Yogurt OILS Canola Coconut Olive Peanut CONDIMENTS Capers Honey Horseradish Jam/Jelly Ketchup Mayonnaise Mustard Pickles Vinegars Wasabi Soy Sauce BBQ Sauce Worcestershire Sauce SOUPS/STEWS Creamed Hot Cold Chunky Smooth COMMENTS or additional preferences for specific ingredients not listed above:
COOKING DAY PREFERENCES Please indicate your preference for package size. Family Style (multiple servings per container) Couple Servings (two servings per container) Individual Servings (one serving per container) As appropriate, given the type of dish Containers I strongly recommend glass containers because they keep your food safer. Toxic substances like BPA (Bisphenol A) can migrate from the plastic to your food during microwave heating. Additionally, the nonporous surface of glass won t absorb germs or odors and can easily be washed at high temperatures, unlike many plastics. Glass will be a bit more of an investment upfront, but will last longer than your plastics, which need to be replaced every 6-12 months because of safety concerns. I will provide reusable plastic containers with lids I will provide reusable glass containers with lids Please purchase reusable plastic containers for me with a prepaid deposit Please purchase reusable glass containers for me with a prepaid deposit Storage Freeze all meals Refrigerate all meals Refrigerate some meals and freeze some meals Although your meals will be refrigerated and/or frozen, most will be intended to be eaten warm so you ll want to reheat them. What type of reheating are you comfortable doing on your own? Microwave at full power Microwave at low power Stovetop Oven
If there are any components that would be best cooked immediately prior to eating, and you are comfortable with doing any final cooking, which methods would you be comfortable doing? Grilling Sauteing Baking/Roasting I only prefer to reheat my food If you are comfortable with doing any final cooking immediately prior to eating, how much time are you willing to spend? 5 minutes maximum 5-10 minutes 10-15 minutes 15-20 minutes