Protect your guests and your operation with a structured allergy disclosure process. This form captures the fourteen most common allergens, severity level, epinephrine auto-injector status, and dietary preferences beyond allergies — giving your kitchen team everything they need to serve every guest safely. Use it for restaurant reservations, school lunch programs, corporate cafeterias, or healthcare dining.
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A food allergy disclosure form is a critical safety document for any operation that serves food to people with medical dietary restrictions. In the United States, the FDA's FASTER Act expanded the major food allergens list to nine, but many guests carry intolerances and sensitivities beyond that list. Capturing this information in a structured, consistent format before service — rather than relying on verbal communication in a noisy environment — reduces the risk of miscommunication and cross-contact incidents.
This template is designed to serve multiple contexts: a restaurant can send it as part of a reservation confirmation, a school dining program can distribute it at enrollment, and a healthcare facility can include it in patient intake. The severity level field is particularly important — it lets kitchen staff understand not just what to avoid, but how urgently they need to avoid it. A guest with a mild intolerance and a guest with anaphylaxis risk require very different protocols.
With formformform, the disclosure can be collected digitally before the guest arrives, stored securely, and referenced when the order comes in. Because every submission triggers an email notification, front-of-house staff are alerted the moment a high-severity disclosure comes in and can brief the kitchen before the guest is seated.
Use your own copy to change labels, remove questions and add the details you need. Try the preview alongside this guide to see what respondents will be asked.
Review the starting questions and choices. You can change them in your own copy.
Jane Smith
jane@example.com
(555) 123-4567
Describe any additional allergens, intolerances, or dietary restrictions...
e.g., vegan, halal, kosher, low-sodium — anything else we should know...
Suggested uses, and why this starting point can help. Adapt the questions to your own process.
Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “I am a” in particular and adapt it to the detail you need.
Part of the student meal plan enrollment process to flag high-risk students for priority kitchen accommodation.
Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Other Allergies or Restrictions Not Listed Above” in particular and adapt it to the detail you need.
Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Allergy Severity Level” in particular and adapt it to the detail you need.
Gather the details needed before making arrangements. Consistent answers help you spot special requirements and prepare the next step. Review “Do you carry an epinephrine auto-injector (EpiPen)?” in particular and adapt it to the detail you need.
Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Dietary Preferences Beyond Allergies” in particular and adapt it to the detail you need.
Ask for the context needed to understand the request before replying. This reduces the back-and-forth needed to establish the basic facts. Review “I am a” in particular and adapt it to the detail you need.
Used by personal chefs to document all household members' restrictions before planning weekly menus and grocery shopping.
Click 'Use this template' to open the form pre-built with all major allergen checkboxes and severity fields.
Add your venue name and any facility-specific language to the introduction paragraph.
Customize the allergen list to include any additional items specific to your cuisine or menu.
Set up email notifications to alert your front-of-house manager and head chef on every submission.
Link the form in reservation confirmation emails or embed it on your booking page.
Review and archive submissions before each service so kitchen staff are briefed in advance.
send the form link in the reservation confirmation so kitchen staff have preparation time before the guest arrives.
the form separates medical allergies from dietary preferences; make sure your kitchen team understands the difference in urgency.
a guest with mild lactose intolerance and one with anaphylactic nut allergy need completely different handling; capturing severity prevents treating all disclosures the same.
the form is only useful if front-of-house and kitchen staff know to check submissions before each service and understand what each field means.
collect only the information needed to serve the guest safely; avoid asking for unrelated medical details.
dietary needs change; build a process for guests to resubmit or update their disclosure for repeat visits.
Sent automatically in the reservation confirmation email so the kitchen can prep allergen-safe meals before the party arrives.
Collected at enrollment to give cafeteria staff a full record of every student's allergen profile for the academic year.
Part of inpatient admission paperwork to ensure food service staff serve medically appropriate meals to every patient.
Distributed to attendees before a company lunch or conference so the caterer can prepare inclusive options for all dietary profiles.
Collected at signup to filter recipe recommendations and flag ingredients that should never appear in a subscriber's box.
Included in the RSVP flow to capture every guest's restrictions so the caterer can plan plated meals and buffet labeling accordingly.
Gathered from parents during camp registration to brief the camp kitchen on each camper's allergies and religious dietary rules.
Completed by new residents or their family members to document long-term dietary restrictions and medication-related food interactions.
Collected from each guest before a culinary walking tour so the guide can confirm safe tastings at each restaurant stop.
Used by personal chefs to document all household members' restrictions before planning weekly menus and grocery shopping.
Part of the student meal plan enrollment process to flag high-risk students for priority kitchen accommodation.
Collected by festival organizers from each vendor to publish an allergen guide for attendees with severe food allergies.
Captures passenger dietary restrictions and allergy severity for special meal code assignments on long-haul flights.
Yes. The form includes fields for severity level and epinephrine status that are directly relevant to clinical and long-term care settings. You can also add a field for the responsible clinician's name or room number.
Absolutely. The allergen checkbox list is fully editable — add any item your kitchen uses that isn't covered by the default list, such as mustard, celery, or lupin.
All formformform submissions are stored on encrypted servers. Access to your form data requires your account login, so only authorized staff can view the disclosures.
Guests can fill out the form again with updated information. You'll see both submissions in your dashboard; it's good practice to mark the earlier one as superseded.
Yes. Many schools use a variation of this form at enrollment. You can add a field for the student's grade, teacher, and parent/guardian name to make it work within your school's workflow.
The checkbox list allows multiple selections, and the open-ended field lets guests add detail. Your notification email will contain all selected items so kitchen staff can review before service.
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