New Client Information Tell us a little bit about yourself – your food likes, dislikes, and dietary requirements, and some delivery contact information. Customize your meals to your personal preferences and needs! DELIVERY INFORMATIONName* First Last Email* Delivery address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Delivery contact phone*How did you hear about Portable Chef?ReferralInternet searchMedia (print article, website, podcast, etc.)Great! Looks like we owe someone a thank-you... Who referred you to us?Thanks! We're always curious to know. Do you happen to remember the search terms you used?Thanks! We're always curious to know. Do you happen to remember which?How many people will be dining?*Can meals be delivered anytime (doorman or other safe place to leave insulated package)*YesNoWhere should meals be left?Doorman (with fridge)Doorman (no fridge)Apartment door (courier must be able to reach apartment door)Front stairs/stoopWhat delivery windows work for you?* Sunday delivery (5-930pm only) 4am-6am (M-F) 6am-8am (M-F) 8am-10am (M-F) 10am-12pm (M-F) 12pm-5pm (M-F) Before 5pm (7 days) 5pm-730pm (7 days) 730pm-10pm (7 days) These delivery options don't work for me What delivery days and times (2-hour window please) would work for you?DIETARY GOALSGeneral diet information (will override individual food preferences below) Paleo diet Weight loss Gluten-free Vegan Vegetarian Great! We've helped many clients lose weight and can do the same for you. So we can dial in portion sizes can you tell us a bit more information - either your current and goal weight and current activity level, or a daily calorie target if you happen to have one in mind?Allergies (will override individual food preferences below)Are you using Portable Chef to help your recovery from illness?YesNoPlease describe the illness you're recovering from.FOOD PREFERENCESMeat/EggsBeefYES!YesNoChicken (on the bone)YES!YesNoChicken (dark meat, off the bone)YES!YesNoChicken (white meat)YES!YesNoPork (aside from bacon)YES!YesNoBaconYES!YesNoTurkeyYES!YesNoLambYES!YesNoGround meatYES!YesNoEggsYES!YesNoAdditional comments about meat preferences (optional)SeafoodWhitefish (flounder, sole, tilapia)YES!YesNoSalmonYES!YesNo"Meaty" fish (tuna, swordfish)YES!YesNoShrimpYES!YesNoScallopsYES!YesNoAdditional comments about seafood preferences (optional)VegetablesVegetarian mealsYES!YesNoRoot vegetables (beets, carrots, turnips)YES!YesNoLight leafy greens (lettuce, arugula, spinach)YES!YesNoAssertive leafy greens (kale, collard greens, chard)YES!YesNoPod vegetables (green beans, snap peas)YES!YesNoCruciferous vegetables (broccoli, cauliflower)YES!YesNoVegetables that are really fruits (tomatoes, eggplant, cucumbers)YES!YesNoMushroomsYES!YesNoAdditional comments about vegetable preferences (optional)FruitBerriesYES!YesNoTropical fruits (mango, banana, pineapple)YES!YesNoCitrus fruits (lemon, lime, orange, grapefruit)YES!YesNoOther tree fruits (apples, pears, peaches)YES!YesNoAdditional comments about fruit preferences (optional)Herbs, spices, and flavoringsOnionsYES!YesNo (I don't like heavy onion flavors)None at all (allergy, etc)GarlicYES!YesNo heavy garlic flavorsNone at all (allergy, etc)CilantroYES!YesNoSpicy hot flavoringsYES!YesNo (a little heat is ok, just nothing really spicy)No (no heat of any kind, please)Green savory herbs (thyme, rosemary, tarragon, sage, parsley)YES!YesNoGingerYES!YesNoAdditional comments about flavoring preferences (optional)GrainsBrown riceYES!YesNoHearty grains (barley, wheat berries, rye, spelt)YES!YesNoPastaYES!YesNoCouscous, bulgurYES!YesNoQuinoaYES!YesNoPotatoesYES!YesNoBreadYES!YesNoAdditional comments about grain preferences (optional)DairyMilkYES!YesNoButterYES!YesNoYogurtYES!YesNoCheeseYES!YesNoOtherNutsYES!YesNoTofu, tempehYES!YesNoSeitanYES!YesNoFavorite dishesCommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.