Name *

First Name

Last Name

Phone *

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Have you ever tried Gluten and or Dairy Free food?

Yes

No

Yes, but it's usually bland and not to my taste

Why do you choose to eat gluten / dairy free?

General health and wellbeing

I have a health condition / allergy

I have a family member with a health condition / allergy and I now eat the same

I don't usually eat gluten / dairy free foods

Are you happy to pay a little more for gluten / dairy free food choices?

Yes

No

What primarily brings you to Cafe Memphis?

Coffee

Gluten and dairy free food choices

I like the food and drink options

Convenience - it's the cafe nearest me