Allergies

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Food Allergies and Sensitivities Form

To better serve you, please complete the following for our culinary team. A member of our management team will review and will contact you within 48-hours.

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Please choose your allergy/ies from the list below *

Fish Shellfish Tree Nuts Peanuts Dairy Eggs Soy Wheat Sesame Other

Other *

How severe is your allergy? *

What triggers your allergy? E.g. ingestion, inhaling, contact, etc. *

Do you wear a medic alert bracelet? *

Yes No

Do you carry an epi pen? *

Yes No

Is there anything else we should know about your allergy? *

Submit

HOME
Employment
About

​Food Allergies and Sensitivities Form

Food Allergies and Sensitivities Form