Personal Menu Consultation Request
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First Name:
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Last Name:
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Phone:
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Email Address:
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Please indicate if you are a:
Visitor
First Year Student
Returning Student
Other
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Anticipated date that you will first be dining on campus:
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Residential Restaurant you will visit and/or frequent:
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Special Dietary Need(s):
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Severity:
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Other information we should know about your dietary needs:
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List common food choices you eat for Breakfast:
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List common food choices you eat for Lunch:
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List common food choices you eat for Dinner:
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Other food choices you commonly eat: