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Do you or do you know someone who suffers from allergies or intolerences?
 
Yes
 
No
 
 
 
What is your/their age range?
 
0 - 10
 
11 - 18
 
19 - 25
 
26 - 32
 
32 - 40
 
41 - 50
 
over 50
 
 
 
What foods would you like on a menu specifically made for you/someone with allergies and/or intolerences?
 
Chicken
 
Beef
 
Lamb
 
Seafood
 
Fish
 
Vegetables
 
Pies
 
Potatoes
 
Rice
 
Burgers
 
Chips
 
Pizzas
 
Sandwiches
 
Bread
 
Pasta
 
Cakes
 
Ice-creams
 
Cookies
 
 
 
Would you prefer to -
 
Eat-in?
 
Take-away?
 
Arrange delivery?
 
 
 
wHAT TIME OF DAY
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually