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PLANT BASED MEAL PREP
Language
English (US)
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1
1. How would you consider yourself?
Vegan
Vegeterian
Pescatarian
None of these
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2
2. Are you allergic to any of the following foods? Please select all that apply.
Peanuts
Tree nuts
Sesame
Wheat/Gluten
Soya
Celery
Mustard
Other
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3
3. Please indicate how much you like the following foods.
Dislike a lot
Dislike
Neutral
Like
Like a lot
Not applicable
Vegetables
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
vegan food
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Nuts
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Fresh herbs
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Row 3, Column 5
Soups
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Row 4, Column 5
Beans
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Row 5, Column 4
Row 5, Column 5
Bread
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Row 6, Column 4
Row 6, Column 5
Cereals
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
Row 7, Column 4
Row 7, Column 5
Rice
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
Row 8, Column 4
Row 8, Column 5
Chips
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Row 9, Column 3
Row 9, Column 4
Row 9, Column 5
Cheese
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Row 10, Column 3
Row 10, Column 4
Row 10, Column 5
Fruits
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Row 11, Column 3
Row 11, Column 4
Row 11, Column 5
Spinach
Row 12, Column 0
Row 12, Column 1
Row 12, Column 2
Row 12, Column 3
Row 12, Column 4
Row 12, Column 5
Mushrooms
Row 13, Column 0
Row 13, Column 1
Row 13, Column 2
Row 13, Column 3
Row 13, Column 4
Row 13, Column 5
Broccoli
Row 14, Column 0
Row 14, Column 1
Row 14, Column 2
Row 14, Column 3
Row 14, Column 4
Row 14, Column 5
Salad leaves
Row 15, Column 0
Row 15, Column 1
Row 15, Column 2
Row 15, Column 3
Row 15, Column 4
Row 15, Column 5
Butter
Row 16, Column 0
Row 16, Column 1
Row 16, Column 2
Row 16, Column 3
Row 16, Column 4
Row 16, Column 5
Cream
Row 17, Column 0
Row 17, Column 1
Row 17, Column 2
Row 17, Column 3
Row 17, Column 4
Row 17, Column 5
Olives
Row 18, Column 0
Row 18, Column 1
Row 18, Column 2
Row 18, Column 3
Row 18, Column 4
Row 18, Column 5
Chocolate
Row 19, Column 0
Row 19, Column 1
Row 19, Column 2
Row 19, Column 3
Row 19, Column 4
Row 19, Column 5
Ice cream
Row 20, Column 0
Row 20, Column 1
Row 20, Column 2
Row 20, Column 3
Row 20, Column 4
Row 20, Column 5
Spices
Row 21, Column 0
Row 21, Column 1
Row 21, Column 2
Row 21, Column 3
Row 21, Column 4
Row 21, Column 5
Salt
Row 22, Column 0
Row 22, Column 1
Row 22, Column 2
Row 22, Column 3
Row 22, Column 4
Row 22, Column 5
Special Condiments
Row 23, Column 0
Row 23, Column 1
Row 23, Column 2
Row 23, Column 3
Row 23, Column 4
Row 23, Column 5
Vegetables
vegan food
Nuts
Fresh herbs
Soups
Beans
Bread
Cereals
Rice
Chips
Cheese
Fruits
Spinach
Mushrooms
Broccoli
Salad leaves
Butter
Cream
Olives
Chocolate
Ice cream
Spices
Salt
Special Condiments
Dislike a lot
Row 0, Column 0
Dislike
Row 0, Column 1
Neutral
Row 0, Column 2
Like
Row 0, Column 3
Like a lot
Row 0, Column 4
Not applicable
Row 0, Column 5
Dislike a lot
Row 1, Column 0
Dislike
Row 1, Column 1
Neutral
Row 1, Column 2
Like
Row 1, Column 3
Like a lot
Row 1, Column 4
Not applicable
Row 1, Column 5
Dislike a lot
Row 2, Column 0
Dislike
Row 2, Column 1
Neutral
Row 2, Column 2
Like
Row 2, Column 3
Like a lot
Row 2, Column 4
Not applicable
Row 2, Column 5
Dislike a lot
Row 3, Column 0
Dislike
Row 3, Column 1
Neutral
Row 3, Column 2
Like
Row 3, Column 3
Like a lot
Row 3, Column 4
Not applicable
Row 3, Column 5
Dislike a lot
Row 4, Column 0
Dislike
Row 4, Column 1
Neutral
Row 4, Column 2
Like
Row 4, Column 3
Like a lot
Row 4, Column 4
Not applicable
Row 4, Column 5
Dislike a lot
Row 5, Column 0
Dislike
Row 5, Column 1
Neutral
Row 5, Column 2
Like
Row 5, Column 3
Like a lot
Row 5, Column 4
Not applicable
Row 5, Column 5
Dislike a lot
Row 6, Column 0
Dislike
Row 6, Column 1
Neutral
Row 6, Column 2
Like
Row 6, Column 3
Like a lot
Row 6, Column 4
Not applicable
Row 6, Column 5
Dislike a lot
Row 7, Column 0
Dislike
Row 7, Column 1
Neutral
Row 7, Column 2
Like
Row 7, Column 3
Like a lot
Row 7, Column 4
Not applicable
Row 7, Column 5
Dislike a lot
Row 8, Column 0
Dislike
Row 8, Column 1
Neutral
Row 8, Column 2
Like
Row 8, Column 3
Like a lot
Row 8, Column 4
Not applicable
Row 8, Column 5
Dislike a lot
Row 9, Column 0
Dislike
Row 9, Column 1
Neutral
Row 9, Column 2
Like
Row 9, Column 3
Like a lot
Row 9, Column 4
Not applicable
Row 9, Column 5
Dislike a lot
Row 10, Column 0
Dislike
Row 10, Column 1
Neutral
Row 10, Column 2
Like
Row 10, Column 3
Like a lot
Row 10, Column 4
Not applicable
Row 10, Column 5
Dislike a lot
Row 11, Column 0
Dislike
Row 11, Column 1
Neutral
Row 11, Column 2
Like
Row 11, Column 3
Like a lot
Row 11, Column 4
Not applicable
Row 11, Column 5
Dislike a lot
Row 12, Column 0
Dislike
Row 12, Column 1
Neutral
Row 12, Column 2
Like
Row 12, Column 3
Like a lot
Row 12, Column 4
Not applicable
Row 12, Column 5
Dislike a lot
Row 13, Column 0
Dislike
Row 13, Column 1
Neutral
Row 13, Column 2
Like
Row 13, Column 3
Like a lot
Row 13, Column 4
Not applicable
Row 13, Column 5
Dislike a lot
Row 14, Column 0
Dislike
Row 14, Column 1
Neutral
Row 14, Column 2
Like
Row 14, Column 3
Like a lot
Row 14, Column 4
Not applicable
Row 14, Column 5
Dislike a lot
Row 15, Column 0
Dislike
Row 15, Column 1
Neutral
Row 15, Column 2
Like
Row 15, Column 3
Like a lot
Row 15, Column 4
Not applicable
Row 15, Column 5
Dislike a lot
Row 16, Column 0
Dislike
Row 16, Column 1
Neutral
Row 16, Column 2
Like
Row 16, Column 3
Like a lot
Row 16, Column 4
Not applicable
Row 16, Column 5
Dislike a lot
Row 17, Column 0
Dislike
Row 17, Column 1
Neutral
Row 17, Column 2
Like
Row 17, Column 3
Like a lot
Row 17, Column 4
Not applicable
Row 17, Column 5
Dislike a lot
Row 18, Column 0
Dislike
Row 18, Column 1
Neutral
Row 18, Column 2
Like
Row 18, Column 3
Like a lot
Row 18, Column 4
Not applicable
Row 18, Column 5
Dislike a lot
Row 19, Column 0
Dislike
Row 19, Column 1
Neutral
Row 19, Column 2
Like
Row 19, Column 3
Like a lot
Row 19, Column 4
Not applicable
Row 19, Column 5
Dislike a lot
Row 20, Column 0
Dislike
Row 20, Column 1
Neutral
Row 20, Column 2
Like
Row 20, Column 3
Like a lot
Row 20, Column 4
Not applicable
Row 20, Column 5
Dislike a lot
Row 21, Column 0
Dislike
Row 21, Column 1
Neutral
Row 21, Column 2
Like
Row 21, Column 3
Like a lot
Row 21, Column 4
Not applicable
Row 21, Column 5
Dislike a lot
Row 22, Column 0
Dislike
Row 22, Column 1
Neutral
Row 22, Column 2
Like
Row 22, Column 3
Like a lot
Row 22, Column 4
Not applicable
Row 22, Column 5
Dislike a lot
Row 23, Column 0
Dislike
Row 23, Column 1
Neutral
Row 23, Column 2
Like
Row 23, Column 3
Like a lot
Row 23, Column 4
Not applicable
Row 23, Column 5
1
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4
4. Which of the following do you consider the most when eating a meal?
Comfort of the place
A good location
Time to cook
Grab and go options
Variety
Taste
Nutrition
Service speed
Price
Portion size
Other
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5
5. Do you usually add salt to your food?
Never
Sometimes
Generally
Always
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6
6. How much water do you drink each day?
Less than 0.5 liters
0.5-1.5 liters
1.5-3 liters
More than 3 liters
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7
What type of foodie are you?
Salty foodie
Sweet tooth
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8
Can you handle spices , chilies?
Yes
No
Mild Tolerance
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9
Describe your favorite Meal or name your favorite meal :
write here
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10
How many meals per day are you planning on ordering?
Once a day
2 Meals a day
Lunch
Dinner
lunch , Snack & Dinner
I would like something specially designed for my needs. ex: juices , smoothies added options
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11
How many days per week ?
All week
Monday to Saturday
Other
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12
Please specify:
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13
Length of your commitment?
1 month meal , 2 months, etc
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14
Do you budget your weekly meals? If yes what is your average weekly spending?
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15
Your delivery choice:
Daily , by lunch time
2 Times per week
Other
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16
Other, Specify:
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17
We work on a 2 weeks minimum period commitment, are you OK with this ?
Yes
No
Other
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18
Other, Specify:
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19
Payment can be made online or by cash before starting date upon request and schedule: ( The online payment option and link will be sent with the quotation/Invoice)
Choose your intended payment method
Via Paypal
Via Stripe
Cash
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20
Name (Optional)
First Name
Last Name
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21
Email (Optional)
example@example.com
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22
Phone Number (Optional)
Please enter a valid phone number.
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23
Address:
Address 1: Street Number & Name
Address 2
City
State
Post Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Pays
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24
Wake up Time:
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25
Bed Time:
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26
Height & Weight:
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27
Please verify that you are human.
*
This field is required.
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