Food Allergy Restaurant Accommodation Feedback

Food Allergy Restaurant Accommodation Feedback — Form Fields

This feedback template includes 9 fields. Gather feedback from diners with food allergies or dietary restrictions on how well restaurants accommodated their needs. Free to customize and use on ZenBuild.

• Type of dietary need (dropdown selection, required) — options: Tree nut allergy, Peanut allergy, Gluten intolerance/celiac, Dairy allergy, Shellfish allergy, Soy allergy, Vegan, Kosher, Halal, Multiple restrictions
• How did you communicate your needs? (dropdown selection, required) — options: During reservation, When seated, To server directly, Via online order notes, I did not communicate
• Server knowledge about allergens and ingredients (rating, required)
• Willingness of staff to accommodate your needs (rating, required)
• Confidence that your meal was prepared safely (rating, required)
• Overall dining experience (rating, required)
• Did you experience any allergic reaction or concern? (multiple choice, required) — options: Yes serious reaction, Yes minor concern, No everything was fine
• Would you return to this restaurant? (multiple choice, required) — options: Definitely, Probably, Unsure, Probably not, No
• Suggestions for improving allergy accommodation (long text, optional)