Healing Meals

Healing Meals

Client Intake Form
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
**Please mark any of the following dietary restrictions or allergies.

This will allow me to call you with neccessary subsitiutions or adjustments to your meals.
Dietary restrictions & Allergies

VeganVegetarianPescatarianNut allergyShellfish allergyLactose IntoleranceGluten IntoleranceDiabetesHigh blood pressureNo porkNo beefOther
Additional Comments:
Meals are $20 each.

To Pay by Venmo, please send to: @divadawg

To Pay by Zelle, please send to: 504-296-3735

To Pay by CashApp, please send to: $chefdivalassair

Invoices will be sent if you request to pay by credit card with a 3.5% fee and 10% Sales Tax.

Delivery & Pickup days and times will be worked out with each client individually.

Weekly menus will be emailed on Friday. Please submit orders and full payment by Noon Sunday.
Who referred you?
Client's Signature

Clear
Should be Empty: