Dietary Needs Questionnaire - BLAAMAZON

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DINNER PARTY

DIETARY QUESTIONNAIRE

We want to be sensitive to our guest dietary needs. Fill out the form below, this will help us prepare dishes that everyone can experience. While we can’t promise we can adhere to all of these, we will do our best to make a dinner party great for all of our guest.

FIRST NAME

LAST NAME

Email

Do you plan on attending the dinner party august 7th?

Yes Likely Maybe

Please check any of the food allergies/dietary restrictions below that apply to you:

Vegan Kosher Nut free Lactose Intolerance Gluten Intolerance (Gluten Free) Wheat Intolerance (Wheat Free) Vegetarian No Seafood n/a

Please briefly describe your dietary needs/allergies and specifically identify their cause(s) (i.e. diabetes, allergies, personal choice).

If your dietary restriction is an allergy, please indicate in which cases you are likely to have an allergic reaction:

You ingest the food? You touch the food? The food is in close proximity? n/a

Please list and further explain your dietary restriction(s) if necessary

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