About this template
Menu planning goes wrong when the only allergy note is a reply-all the day before. This questionnaire asks for a diet type, a written allergy list, a free-text rating of foods they like, what drives their meal choices, how often they use salt, and how much water they drink. Name, email, and phone sit at the end so you can match the answers to a person.
Diet type is a short list: no specific diet, vegetarian, vegan, pescatarian, gluten free, or other. Priorities are checkboxes, so someone can care about both price and health. Salt is a frequency, not a medical score. The ratings field is a paragraph because the source was a grid of foods you may not serve. Rewrite that prompt with your own menu once the form is yours.
Caterers, office managers, and dietitians can all start here. It is a preference sheet, not a diagnosis and not a substitute for a clinical intake.
Key features
- Diet type is a dropdown instead of a blank people answer three different ways.
- Allergies stay in one written list, including an explicit none.
- Meal priorities allow more than one answer.
- Salt use and water intake are separate from likes and dislikes.
- Contact fields sit at the end so the food questions come first.
Use cases
- Catering for a retreat, wedding, or company offsite.
- A dietitian collecting preferences before the first visit.
- A cafeteria or meal-plan survey.
- A restaurant group testing a new menu with regulars.
What this form collects
- Diet Type (Dropdown)Pick the closest match.
- Food Allergy List (Paragraph)List each allergy. Write none if you have no food allergies.
- Food Preference Ratings (Paragraph)A sentence or two is enough.
- Meal Decision Priorities (Checkboxes)Select every option that applies.
- Salt Usage Frequency (Multiple choice)Pick the closest match.
- Daily Water Intake (Short answer)A number or short range is enough.
- Full Name (Short answer)Short answer.
- Email (Short answer)Use an address you actually check.
- Phone Number (Short answer)Include a country code if you are not in the same country.
FAQ
Is this a medical form?
No. It records what someone likes and any allergies they choose to list. A clinical visit needs its own intake.
How should allergies be written?
One list, in their own words. The hint tells them to write none if they have no food allergies, so a blank is not a mystery.
Can I swap in my real menu?
Yes. Replace the ratings paragraph with checkboxes or a grid of the dishes you actually serve.
Why is salt a separate question?
The source form asked it on its own, apart from general likes. Keep it if you cook for people who watch sodium. Delete it if you do not.
Can respondents stay anonymous?
Name, email, and phone are on the form because the source collected them. Turn those off in the Forms editor if you only need counts.
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