Luxury Fiji Resort - All Inclusive - Private Island Resort ...



Food Allergies and Intolerances FormOnly complete this form if you have a food allergy or special dietary need.Arrival Date: _____Departure Date: ______Villa #?: _____Guests Name: ______________________________________________Age: _____________*FOOD ALLERGY (Foods you need to avoid completely)___Lactose___Soy ___Eggs ___Peanuts ___Tree nuts___Fish ___Shellfish ___Crustacean___Gluten (celiac disease or non-celiac gluten sensitivity, includes wheat, barley, oats, rye)Other, please list: _____________________________________________________*FOOD INTOLERANCE (Foods you need to reduce in your diet)___Lactose___ Soy___Gluten (celiac disease or non-celiac gluten sensitivity, includes wheat, barley, oats, rye)Other, please list: _____________________________________________________Are you?___Vegan___VegetarianOther Special Diet needs or restrictions (i.e., Diabetes, IBS, other):______________________________________________________________Dietary Needs QuestionnairePlease answer the following questions to better help us with your needs:What are the preferred food substitutions, if any? (gluten- free breads, soy milk etc):What types of contact will cause a reaction?_____Airborne ____Trace Cross Contact ____Actual ingestion of foodPlease explain:Is the food allergy able to be managed on site if an incident does occur? Please explain so we can help if needed.Is there any other information you would like to share to help us meet your needs? ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download