Meal Plan Intake

The meals prepared for you are 80-100% organic and seasonal, depending on availability. I ask that you reuse OR return the non-compostable containers you receive, so I can sanitize them properly and reuse them. The questions below help me ensure you are receiving the food best suited for your palate, so please give as much thought to the answers as possible. 
 

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* 1. What is your reason for a plant-based meal plan?

  Least important Most important
Weight loss
Disease prevention/treatment

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* 2.

What previous diets or detox programs have you tried, and what did you like and dislike about them?
(This helps me determine how we can make you successful on my meal plans.)

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* 3. Are you prone to snacking? If so, do you crave sweet or salty foods?
Please also list any “weaknesses” that you feel you have, with regard to food.

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* 4. How active are you/what is your current workout plan?
The types of foods in your meal plan can be adjusted, based on your activity level-the more active you are, the more fuel you need.

  Sedentary Very active
Activity level

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* 5. How long of a program are you interested in?

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* 6. How many meals are best for you?

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* 7. Do you have any food allergies/intolerances?
Please also list any health concerns you would like addressed, and I will do my best to accommodate these. Are there any foods you dislike? Some examples are: olives, kale, tofu, asparagus, artichokes, beans, tempeh. Do you have intolerance for sweet, salty, or spicy foods? If so, which?

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* 8.

Delivery information
Note: Delivery times range from 4-7 pm, depending on my delivery route for that day. You will be contacted with the estimated time of delivery. 

DISCLAIMER: This information and meal plan is complimentary to any healthcare you are currently receiving, and is not meant to take the place of health care or services you may need. Please continue any medication and care that you are receiving.  Please also follow up with your Dr. for regular check-ups, to make sure all care is administered correctly, as there may be changes in things such as blood pressure, weight, etc.  These changes can positively affect the amount of care you are receiving.

* Typing your name in the section marked "digital signature" serves as your consent. Your digital signature acknowledges that you have completed this form, and are aware of all disclaimers therein.  By signing above, you acknowledge that you have read the above information, agree to continue any medical care as needed, and you release Pandora’s Lunchbox from any adverse effects you may have.  You also agree that payment is due before or on the first day of delivery, and that if you decide to cancel at any point during the week, there is a non-refundable fee of 40% that was used to plan and purchase the food for your meal plan.


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Thank you for taking the time to fill out this brief questionnaire. Your feedback helps us tailor meals to your specifications and health concerns. If you have any additional comments you would like to share with us, please do so in the space provided below.
 

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* 9. Additional comments

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