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Dietary Requirements
Resident Name...........................................................................................................Room#.................................
Foods They Can’t Have
Allergic to:............................................................................................................................................................. ................................................................................................................................................................................... ................................................................................................................................................................................... Diet Restrictions:................................................................................................................................................ ................................................................................................................................................................................... ...................................................................................................................................................................................
Foods They Don’t Like
................................................................................................................................................................................... ................................................................................................................................................................................... ...................................................................................................................................................................................
Foods They Like
General: .................................................................................................................................................................. ................................................................................................................................................................................... Typical Breakfast................................................................................................................................................ ................................................................................................................................................................................... Typical Lunch:...................................................................................................................................................... ................................................................................................................................................................................... Typical Supper: ................................................................................................................................................... ...................................................................................................................................................................................
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