FOOD CONSULTATION FORM
Your food should be eaten mindfully and with gratitude, and that it must be fresh, of the highest quality, digestible, delicious, lovingly prepared and satisfying to your senses. Our food are offered a balanced approach to preparing, eating and digesting your food based on your unique body-mind type or Dosha, as well as the time of day, the season, and your life-cycle.
Please choose the items that you need to avoid:
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DATE
NAME
CONTACT
CARBOHYDRATE
RED RICE
POTATO
OATS
BANANA
ORANGE
CORN
DAIRY
SOY MILK
COCONUT MILK
COW MILK
VEGAN CHEESE
YOGURT
CASHEW BUTTER
PROTEIN
RED BEAN
NUTS
OATMEAL
AVOCADO
EGG
TUNA
CHICKEN
OTHER
Other
METHOD OF COOKING
STEAM
BOILED
STIR-FRY
SWEET
RAW HONEY
BROWN SUGAR
WHITE SUGAR
VEGETABLE
BEAN SPROUTS
BELL PEPPERS
BROCCOLI
CABBAGE
CELERY
CAULIFLOWER
CILANTRO
CRESS
GREEN BEANS
GREEN PEPPERS
KALE
LETTUCE
GREENS LETTUCE
MUSHROOMS
PEAS
PARSLEY
PUMPKIN
CARROT
FOOD INTOLERANCE
GLUTEN-FREE
DAIRY FREE
CAFFEINE
OTHER
Other
FOOD ALLERGIES
COW’S MILK
EGGS
TREE NUTS
PEANUTS
SHELLFISH
WHEAT
OTHER
Other
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I AGREE AND PROCEED WITH FOOD CONSULTATION