Client Assessment Form

Thank you very much for considering Persimmon Personal Chef Service.
Please fill out the form below so we can get to know each other better.




  • Yes (Please list below)
  • No






  • Bland 
  • Mild 
  • Medium 
  • Hot 
  • Very Hot 

  • Yes 
  • No 

  • Yes (Please list below)
  • No


  • Gas 
  • Electric 
  • Yes 
  • No 

  • Gas 
  • Electric 
  • Yes 
  • No 

  • Yes 
  • No 

  • Yes 
  • No 

  • Yes 
  • No 

  • Yes 
  • No 
  • Sometimes 
  • Unknown 



  • Yes 
  • No 

  • Yes 
  • No 

  • Yes 
  • No 


Serving Portland, OR | Beaverton, OR | Hillsboro, OR | West Linn, OR | Lake Oswego, OR | Vancouver, WA

© 2017 Persimmon Personal Chef Service®, LLC | Portland, Oregon | 971.255.0822