The Pickled Beet Food Questionnaire

  • We Create A Personalized Menu For Each Client Every Week

    Imagine going into a restaurant, looking at the menu, and realizing that every dish on it is one of your favorites. At The Pickled Beet, every client gets their own personalized menu every week. Please take a few minutes to tell us about your preferences, foods you'd like excluded, allergies, and any dietary restrictions so we can plan a menu just for YOU!

  •  INSTRUCTIONS

    Please complete the following form so we can learn exactly what you like, don't like, and any food restrictions or concerns you have. 

    Once submitted, you will be redirected to schedule a 15-minute consultation with our head chef. Don't skip this step - we want to make sure we have all the details down to get you exactly what you want!

    Our schedule books up extremely fast so be sure to book ASAP to choose your preferred date and time.

    The Pickled Beet Family is looking forward to cooking for you!

  • Format: (000) 000-0000.
  • Is this a cell phone?*
  • How did you hear about The Pickled Beet®?*
  • Is it OK to use wine/alcohol in your meals?*
  • Would you like Vegetarian/Vegan entrees?*
  • What are your favorite cuisines?*

  • MEATS & POULTRY

    Please tell us which items to EXCLUDE in your meals.
  • Meats & Poultry I do not want:*
  • Chicken cuts I do not want:*
  • Turkey cuts I do not want:*

  • SEAFOOD

    Select the items to EXCLUDE in your meals.
  • Seafood I do not want:*
  • Fish I do not want:*

  • Non-Meat Products

    Please identify any non-meat ingredients you WOULD LIKE in your meals, if any, such as tofu, Beyond Meats, tempeh, etc.

  • VEGETABLES & FRUITS

    Select the vegetables and fruits that you would NOT LIKE to be included in your meals. We will exclude the items you select. If you have special notes, such as I only like cooked onions, etc. don't check the item and include that note in the comments section below.
  • Vegetables and Fruits I do not want:*
  • Olives I do not want:*

  • GLUTEN & GRAINS

    Select the legumes, grains, pastas, breads and seeds that you would like EXCLUDED in your meals.
  • BEANS I do not want:*
  • GRAINS/PASTA I do not want:*
  • BREADS I do not want:*
  • NUTS & SEEDS I do not want:*

  • FLAVOR PREFERENCES

  • Preferred Spice Level:*

  • DAIRY

    Select dairy items you would like us to EXCLUDE in your meals.
  • DAIRY items I do not want:*
  • NON-DAIRY items I do not want:*
  • My dairy preferences and issues are "complicated" (please check all that DO apply and then add any notes):*
  • EGGS I do not want:*

  • NEXT STEPS

    Service Details, Billing Details & Scheduling Consultation
  • What type of meals are you interested in?*
  • Meal Schedule:*
  • Sides:*
  • Will you occasionally want some meals and/or snacks prepared to eat outside of your home, such as at the beach, on your yacht, or when you fly via private air travel? (check all that apply)

  • HANG IN THERE, YOU'RE ALMOST DONE!

     Please complete the following billing questions. Notice that we will not be asking you for your credit card number at this moment, as we will be securely collecting that information over the phone at the end of your consultation.

    Once you submit the Food Questionnaire, you will be redirected to a Calendly link where you can schedule an appointment at your convenience for a 15-minute consultation, during which you will go over your answers to the questionnaire and plan options.

  • Is your billing address the same as delivery address?

  • MEDICAL ADVICE DISCLAIMER

    DISCLAIMER: THE PICKLED BEET DOES NOT PROVIDE MEDICAL ADVICE

    This information, including, but not limited to, text, graphics, images, or other material contained in this form, or any communication (verbal or written) is for informational purposes only. No material on this form, or dicussion relating to it, is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment, and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because or something you have read or discussed with any member or contractor with The Pickled Beet. 

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