Name * First Name Last Name Email * Phone (###) ### #### DIETARY RESTRICTIONS & FOOD ALLERGIES * Lactose intolerant Allergy to nuts Diabetic Gluten free Other No dietary restrictions SELECT THE NUMBER OF MEALS PER DAY YOU PREFER * 1-2 3-4 5-6 DO YOU PREFER ANY OF YOUR MEALS TO BE LARGER THAN THE OTHERS? * Breakfast Lunch Dinner None TO SAVE TIME, DO YOU WANT TO BE EATING THE SAME? Breakfast Lunch Dinner Dairy Milk Eggs Yogurt Butter Cheese Sour Cream Cottage Cheese None of the above NUTS & SEEDS Peanuts Walnuts Brazil nuts Hazelnuts Hemp seeds Chai seeds Sesame seeds Almonds Cashews Pistachios Pine nutes Sunflower seeds Flax seeds Tahini FRUIT Avocados Bananas Apples Kiwi Watermelon Figs Blackberries Blueberries Strawberries Cantaloupe Papaya Pineapple Dates Pomegranate Raspberries Nectarines Peaches Lemons Limes Grapefruit Organges Clementine's Plums Cherries Apricots Honeydew Mango VEGETABLES Kale Arugula Spinach Collard greens Broccoli Cabbage Brussel sprouts Carrots Cucumber Artichokes Celery Potatoes Sweet Potatoes Winter squash Peas Green beans Tomatoes Mushrooms Eggplant Acorn squash Butternut squash Cauliflower Cabbage Zucchini Parsnips Turnips Rutabagas Asparagus Bell peppers Beets Onion Garlic BREAD White Wheat Tortillas Rice cakes GRAINS Corn Quinoa Ferro Millet Barley Oats Brown rice White rice Buckwheat White pasta Wheat pasta PROTEIN SOURCES ANIMAL Beef Chicken Roast beef Turkey Pork Chorizo Salami Ham Lunch meat PROTEIN SOURCES SEAFOOD Scallops Tuna Fish Clams Shrimp Lobster Crab PROTEIN SOURCES BEANS Chickpeas Black beans Kidney beans Lentils Brown beans CONDIMENTS Honey Guacamole Mustard Mayo Vinegar Thank you!