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Dietary Restrictions Form Template

Streamline dietary information collection for your food service

Ensuring everyone's dietary needs are met can be challenging, especially in large settings. This Dietary Restrictions Form Template helps schools, event planners, and caterers gather crucial dietary information from participants quickly and accurately. By using this template, you can easily identify food allergies, accommodate various diets, and enhance the dining experience for all attendees, while also promoting compliance with health standards. Get started with the live template and simplify your dietary data collection process.

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Full name
Email address
Phone number
Organization or event name
Date the meal is needed
Do you follow any dietary lifestyle?
Please Specify:
Religious or ethical requirements (select all that apply)
Please Specify:
Which allergies or intolerances do you have? (select all that apply)
Please Specify:
Other allergies or intolerances (please specify)
How severe are your reactions if the restricted food is consumed?
No reaction; avoidance is by choice
Mild discomfort
Moderate symptoms
Severe; risk of anaphylaxis
Not sure
Prefer not to say
How sensitive are you to cross-contact (trace amounts)?
Must avoid any cross-contact
Prefer to minimize cross-contact
Cross-contact is acceptable
Not sure
Not applicable
Foods or ingredients to avoid (please list)
Are advisory labels such as 'may contain' or 'processed in a facility with' acceptable to you?
Yes
No
Not sure
Preparation and packaging preferences (select all that apply)
Use separate utensils and surfaces
Dedicated fryer (no shared oil)
Individually packaged and labeled
Provide full ingredient list
Serve sauces/dressings on the side
No garnishes
Simple seasoning only
None
Other
Please Specify:
Safe foods, brands, or substitutions you prefer
Have your dietary restrictions been diagnosed or advised by a clinician?
Yes
No
Not sure
Prefer not to say
Emergency contact full name
Emergency contact phone number
Do you carry emergency medication (e.g., epinephrine)?
Yes
No
Not applicable
Prefer not to say
Preferred contact method for follow-up
Email
Phone call
Text message
No follow-up needed
Type your full name to confirm the information is accurate
Date
I consent to this information being shared with relevant staff or caterers for meal planning.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Paper art illustration depicting a dietary restrictions form with various food icons and text elements.

When to use this form

Use this form any time you serve food or drinks and need to accommodate guests. It is ideal for event RSVPs, catering requests, team lunches, trainings, camps, or delivery orders. You capture allergies, intolerances, eating patterns (vegan, vegetarian), and faith-based rules (halal, kosher) before you shop or prep. Add it to your order flow to reduce last-minute changes, avoid risk, and set clear expectations. For a smooth checkout, pair it with the Meal order form and the Custom cake order form. If you host tasting events with boards or pairings, attach it to the Wine blind tasting form.

Must Ask Dietary Restrictions Questions

  1. Do you have any food allergies? Please list them.

    This protects guests and reduces liability by surfacing severe reactions early. Specific allergens let you remove or flag risky items across courses.

  2. Which eating patterns do you follow (e.g., vegetarian, vegan, halal, kosher)?

    Clear categories make it easy to batch menus and assign safe options. You avoid guesswork and plan portions that respect personal or faith needs.

  3. Do you avoid any ingredients due to intolerance (e.g., lactose, gluten, soy)?

    Intolerances often need different prep than allergies, so this informs substitutions, marinades, and sauces. It also helps you write accurate labels for self-serve settings.

  4. How strict are your requirements (strict, flexible, cross-contact OK/not OK)?

    Knowing tolerance for cross-contact guides prep stations, utensils, and packaging. It prevents overpromising and keeps costs in line with the risk level.

  5. What should we know about preparation or serving (cross-contact, preferred substitutes, notes)?

    Open notes capture edge cases like shared fryers, gelatin, alcohol in sauces, or spice heat. You can revisit these details with your Restaurant feedback form to confirm satisfaction after the meal.

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