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Food Form

Please fill out our food questionnaire to get started with our meal delivery service! Please allow about 20-30 minutes to fill out the entire form. Once submitted, we will be in touch shortly!

Food Questionnaire

Name(Required)

First Last

Email(Required)

Phone(Required)

How did you hear about Chef Wes?(Required)

Other Adults

Children (with ages)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Best Day and Time to Reach You

Preferred method of Contact

Phone

Email

Text

If you Googled us, what keywords did you use?

Dietary Likes

Please check the boxes of the items that you like only and place notes in the comment section.

Meats

Beef (steak/roasts/ground round) Steak cooked

Pork (chops/roasts/ribs/bacon/ham/ground)

Lamb (chops/stew/ground/roasts)

Meatloaf

Bison

Comments (Meats)

Chicken (breasts/thighs/ground, etc.)

White Meat

Dark Meat

Mixed

Turkey (breasts/smoked/ground, etc.)

Chicken or turkey meatloaf

Comments (Chicken)

Fish/Shellfish

Fish (bass, yellowtail, halibut, salmon, snapper, etc.)

Shrimp

Scallops

Crab

Lobster

Comments (Fish/Shellfish)

Salads

Fresh Green (choice of greens/lettuces, such as Romaine, red leaf, bibb, mixture, spinach, etc.)

Fruit in your salad

Salads as a main dish

Comments (Salads)

Salad Dressings (List Other Salad Dressings in Comments)

Ranch

Vinaigrette (any)

Honey Mustard

Comments (Salad Dressings)

Soups and Stews

With meat/poultry?

Soups/Stews as a main dish?

Creamed

Comments (Soups and Stews)

Vegetables (List vegetables you will not eat in the comments.)

Green (peas, green beans, spinach, asparagus, peppers, cabbage, pea pods, celery, brussel sprouts, mustard greens/greens, broccoli, zucchini, avocadoes, poblanos, okra, kale, swiss chard)

Yellow (corn, wax beans, squash, peppers)

Red (pimento, red cabbage, beets, tomatoes, peppers, sweet potatoes/yams, carrots)

White (cauliflower, potatoes, parsnips, water chestnuts, bamboo shoots, bean sprouts, onions, mushrooms, leeks)

Beans (black, ranch-style, pinto, kidney, lima, white, pink, black-eyed peas, split peas)

Capers, black olives, green olives, coconut, artichokes, eggplant

Comments (Vegetables)

Grains

Combined

Muffins

Pancakes / Waffles

Tortillas (corn, white or wheat)

Comments (Grains)

Breads

Cornbread

Muffins

Pancakes / Waffles

Tortillas (corn, white or wheat)

Comments (Breads)

Seasonings (List seasonings you will not eat in the comments)

Oregano, sage, rosemary, tarragon, fennel, cumin, cilantro, paprika, parsley, celery, chili powder, curry

Fresh garlic, parsley

Pepper - white, black or red

Salt - Kosher (food is prepared very low in salt so that you may season to taste)

Comments (Seasonings)

Fats and Oils

Butter

Olive Oil and other healthy oils (sesame, walnut, pecan, avocado, truffle, etc.)

Is it okay to cook with wine?

Yes

No

Comments (Fats/Oils/Wine)

Milk and Milk Products

Milk

Cheese

Sour Cream

Cream

Cottage Cream

Comments (Milk and Milk Products-Also list any cheeses you won't eat)

Eggs

Whole

Yolks Only

Other

Dried Fruits

Nuts (pecans, peanuts, walnuts, almonds, cashews, Brazil, etc.)

Pizza

Comments (Eggs and Other)

Fruits Disliked

List any known food allergies

Spicy foods - bland/mild/moderate/very hot

Do you have any favorite recipes that I can prepare for you?

Cuisines liked (Mexican/Curries/Italian, Home-style)

Favorite food/restaurants

Which meals (Breakfast, Lunch, Dinner, Snacks and Dessert)

Number days a week you/your family will eat prepared food

Number of servings for each meal

Portion Control (Yes or No)

Service Frequency (weekly, bi weekly, bi monthly, monthly)

Sides with service (1 side with each entree or 2 with each entree)

Organic or Non-Organic Groceries

Organic

Non-organice

No preference

Any other comments or questions

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Let’s Chat!

(502) 438-9164

wes@chefwes.com

Louisville, KY

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