Private Chef Membership Questionnaire

Section 1

Contact Information

Full Name

Email Address

Phone Number

Neighbourhood / Delivery Area

Preferred Method of Communication

Email Phone Text / SMS Instagram DM

Section 2

Household Details

Tell us about your household.

Number of Adults

Number of Children

Typical Weekly Schedule

Do you travel frequently?

Yes, often Occasionally Rarely No

How many meals per week would best support your lifestyle?

Section 3

Culinary Preferences

Foods you love

Foods you avoid

Section 4

Wellness & Dietary Needs

Allergies or sensitivities

Dietary restrictions

Health or wellness goals

Preferred balance of meals

Mostly wellness-focused Balanced mix Leaning indulgent Fully indulgent

Section 5

Membership Interest

Which membership are you most interested in?

Essential — 6 meals / $420 per week Reset — 12 meals / $840 per week Household — 20 meals + snack / $1,320 per week Custom Chef — fully bespoke Unsure / would like guidance

Section 6

Lifestyle Questions

What would make this service most valuable to you?

Saving time Reducing decision fatigue Eating healthier consistently Supporting family routines Hosting support Athletic performance Convenience while traveling

Anything else?

Section 7

Anything Else?

Is there anything else you'd like us to know about your lifestyle, preferences, or ideal experience with Gaia Kitchen?

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Estimated total

Private Chef Membership Questionnaire

Contact Information

Household Details

Culinary Preferences

Wellness & Dietary Needs

Membership Interest

Lifestyle Questions

Anything Else?

Private Chef Membership Questionnaire

Contact Information

Household Details

Culinary Preferences

Wellness & Dietary Needs

Membership Interest

Lifestyle Questions

Anything Else?

Join the club

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