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5 Spice Chef

About
Services
Testimonials
Getting Started
Contact Us

Getting Started

Let’s Get To Know Your Tastes and Dietary Needs!

Meal Plan Client Assessment

Once you’ve decided that you’re ready for some amazingly curated meal plans, please set aside a few moments to help me get to know your tastes and dietary needs by filling out the form below.

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Progress – Step 1 of 7

Name *

First

Last

Email *

example@example.com

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Preferred Method of Communication *

Birthdate *

Entrees and Sides

Please mark ALL that apply.

Do you consider yourself an adventurous diner? *

Yes
No

What level of spiciness do you enjoy in cuisine? *

None
Mild
Medium
Hot
Fiery

Which types of global cuisine do you enjoy? *

Asian
French
Italian
Mexican
Thai
Mediterranean
Other

Do you enjoy vegan options? *

Yes
No

Do you enjoy vegetarian options? *

Yes
No

How many times a month do you enjoy the following?

Beef *

Never
1-2 times
3-4 times
5+ times

Does will us

Pork *

Never
1-2 times
3-4 times
5+ times

Turkey *

Never
1-2 times
3-4 times
5+ times

Fish *

Never
1-2 times
3-4 times
5+ times

Shellfish *

Never
1-2 times
3-4 times
5+ times

Chicken *

Never
1-2 times
3-4 times
5+ times

Game *

Never
1-2 times
3-4 times
5+ times

How do you prefer your meat, on the bone or off?

Beef *

On
Off
Both

Pork *

On
Off
Both

Chicken *

On
Off
Both

Do you prefer a specific cut of meat?

How do you like your meats prepared? (Where applicable) *

Blue
Rare
Medium Rare
Medium
Medium Well
Well

What flavor levels do you prefer when enjoying seafood? *

Mild
Medium
Strong

Do you like the skin on your meat? *

Yes
No

Do you typically eat bread or rolls with your meals? *

Yes
No

Do you like nuts in main dishes, sides or salads? *

Yes
No

How do you prefer your vegetables? *

Raw
Crisp/Tender
Tender
Soft

Soups

Do you enjoy soup as a main dish? *

Yes
No

Which types of soup do you enjoy? *

Hearty
Broth Based
Creamy
Light
Chunky
Hot
Cold

Do you prefer bread or crackers with your soup? *

Bread
Crackers
No, thanks

Salads

Do you enjoy salad as a main dish? *

Yes
No

Do you prefer a variety of greens? *

Iceberg
Baby Spinach
Spring Mix
Other

What type of homemade dressings do you like? *

Classics
Vinaigrettes
Fruity
Creamy

What is your favorite type of dressing? *

Specifics

What meals would you like included in the plan? Think about family favorites. *

How many portions would you like for each recipe? *

How many recipes would you like each week? (Think about- how often do you plan to cook? So your grocery list makes sense for the week) *

Would you eat the same meal as leftovers? *

Yes
No

Is there a specific grocery retailer you prefer?

Are there any cuisines, spices, or seasonings you do not care for? *

Do you enjoy entrees cooked with wine or liquor? *

Yes
No

Dietary Needs

Do you or anyone in your family have any medical conditions/situations that you would like to manage with diet? *

Yes
No

If you selected yes above, please select all that apply. *

Diabetes
High Cholesterol
Low Fat
Cardiac Conditions
No Fat
High Blood Pressure
Light Salt
No Salt
Digestive Disorder
Other

If you selected 'Other' above, please explain.

Do you or anyone in your family have a gluten allergy? *

Yes
No

Are you or anyone in your family lactose intolerant? *

Yes
No

Does anyone in your household have any other allergies or sensitivities? If so, please list here

Would you like portion control? *

Yes
No

Are you or anyone in your family trying to lose weight? *

Yes
No

Food Dislikes

Please indicate food preferences by checking **DISLIKES**.

Vegetables

Beans

Black Beans
Butterbeans
Cannelini (White Kidney)
Garbanzo (Chickpeas)
Great Northern
Lentil
Navy
Pinto
Red
Refried

Grains

Barley
Couscous
Grits/Polenta
Hominy
Quinoa
Rice, Arborio
Rice, Brown
Rice, Jasmine
Rice, White
Rice, Wild
Wheat

Herbs and Spices

Allspice
Anise
Basil
Caraway
Chervil
Cilantro
Cinnamon
Cloves
Coriander
Cumin
Curry
Fennel
Five Spice
Ginger
Marjoram
Mint
Mustard
Oregano
Paprika
Parsley
Pepper, Black
Pepper, White
Rosemary
Sage
Savory
Sesame
Tarragon
Thyme
Vanilla

Pasta

Angel Hair
Egg Noodles
Fettuccini
Linguine
Orzo
Penne
Shells
Spaghetti
Thin Spaghetti
Whole Wheat
Ravioli
Tortellini
Wheels
Ziti

Cheeses

American
Blue
Brie
Cheddar
Cheddar, Sharp
Colby
Cottage Cheese
Cream Cheese
Feta
Fontina
Goat
Gorgonzola
Gruyere
Jalapeno
Monerey Jack
Mozzarella
Parmesan
Ricotta
Swiss

Seeds and Nuts

Almonds
Cashew
Coconut
Hummus
Macadamia
Pecan
Peanuts
Pesto
Pistachios
Sesame
Sunflower
Tahini
Walnut

Fruits

Apple
Apricot
Banana
Blackberry
Blueberry
Cherry
Fig
Grapes
Melon
Nectarine
Gooseberry
Kiwi
Peach
Pear
Pineapple
Plum
Raspberry
Strawberry
Watermelon

Condiments

Ketchup
Mayo
Mustard, Dijon
Mustard, Ground
Mustard, Yellow
Tartar
Vinegar, Apple Cider
Vinegar, Red Wine
Vinegar, Balsamic

Proteins

Beef
Chicken
Eggs
Ham
Fish, Cod
Fish, Mahi Mahi
Fish, Salmon
Fish, Trout
Fish, Tuna
Game
Lamb
Lobster
Meat Substitutes
Pork
Shellfish (Mussels, Scallops)
Shrimp
Tofu
Turkey

Others

Breads
Sour Cream
Yogurt
Milk
Cream
Chocolate

Kitchen Equipment

Please let me know what equipment you have so I can plan accordingly. Select Yes or No.

Crockpot

Yes
No

Instant Pot

Yes
No

Blender (Vitamix or similar)

Yes
No

Blender (Low Power Model)

Yes
No

Food Processor

Yes
No

Spiralizer

Yes
No

Grill

Yes
No

Rice Cooker

Yes
No

Air Fryer

Yes
No

Meal Plan Client Agreement

(In-Home Meal Prep Clients- Please Skip This Section)

We (5 Spice Chef LLC and Client) have completed a Client Assessment to determine what and how you would like to eat, whether or not there are dietary needs (ie. Allergies, sensitivities or medical concerns). I will use this information to design a custom meal plan for you and/or your family. We have reserved your weekly meal plans to start on Friday (pick date below) to be emailed by 8:00 AM.

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Date

The cost of the plan for dinners only is $60/week. Detailed meal prep instructions for dinner only plan is additional $15/week. The cost of the plan for all meals planned to include: breakfast, lunch, dinner, and 2-3 snacks a day is $80/week. Meal Plans is to eliminate the what's for dinner fatigue. You the client does all the cooking when selecting the option of a meal plan.

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What meals would you like planned?

I strive to make cuisine within your specific dietary preferences, however please as always, seek the advice of a doctor prior to making any significant lifestyle changes.

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The information provided in this plan is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. None of my services shall be used to diagnose or treat any health problem or disease. I cannot and do not provide medical advice. You should seek prompt medical care for any specific health issues and consult your physician before altering your diet. The information and recipes provided in this plan should not be used in place of a consultation with your physician or other health care provider. I do not recommend the self-management of health problems. Should you have any healthcare-related questions, please consult your physician or other health care provider promptly. You should never disregard medical advice or delay in seeking it because of the information provided in this plan.

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Payments for meal plans will be due weekly on Fridays via Venmo or Paypal. I will send the suggested menu plan by Wednesday for the next week. You can and should provide feedback/make changes and requests as necessary. The week’s meals are discussed in accordance with dietary needs and personal tastes. Please respond as soon as you can so I can plan accordingly. ***First time clients: you will need to prepay for your first plan. ***

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Cancellation Policy: If you need to skip a week due to travel or other obligations, please inform us of any dates as far in advance as possible (by Monday at the latest). Thank you for your understanding and respect for my time and schedule!

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CONTACT US

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Email: chefmaya@5picechef.com

Call: 904-580-7035

AREAS WE SERVE

Florida, Jacksonville, Jacksonville Beaches, Atlantic Beach, Neptune Beach, Mandarin, Nocatee, and Ponte Vedra Beach.

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