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To give you the best possible experience, please complete form below and then click submit at the bottom. You must place your order by Wednesday, to start receiving your Enlightened Cuisine for the following week's delivery.


General Information
First Name:
Last Name:
Sex:
 Male    Female
Height:
 Ft    In
Age:
Current Weight:
 lbs
Pounds to Lose:
 lbs
Desired time frame to reach your goal
(we recommend responsible
weight loss of 2 pounds per week) :
 Less than 1 month
1-3 months
3-6 months
6 or more months

Delivery/Shipping Information
Street Address:
Apt/Suite #:
Apartment or Subdivision Name:
City:
State:
Zip Code:
Other information needed
for delivery driver to get to
you address:
(example: gate code, beware of dog)
Email:
Phone 1:
 Ext:
Phone 2:
 Ext:
Fax:

Billing Information
(If different from above shipping information)
Street Address:
City:
State:
Zip Code:

Order Information
Please enter the date you would like service to begin: (mm/dd)

Please select your meal plan below:
  Plan Pay as you Go
(By Week) 		Lump Sum Payment Bonus
30 Day Plan $279.65
plus $15/week surcharge* 		$1195.00 Entered in contest to win a free cooking class ($225 value)
90 Day Plan $279.65
plus $15/week surcharge* 		$3593.00 Free cooking class
120 Day Plan $279.65
plus $15/week surcharge* 		$4795.00 Free cooking class.

Graduate to our custom whole foods program and receive 3 days of free meals

5% discount off all future meals

Please select your payment terms:
Pay As You Go
Lump Sum

* For each Pay-as-you-go plan, charges are drawn automatically at the beginning of each week (Tuesday) unless the customer cancels in writing 3 business days before the next payment is due.

Microwave Safe: Containers safe to heat only in the microwave
Oven Safe: Containers safe to heat in toaster oven or conventional oven

Shipping/Delivery Method:

*Meals are delivered fresh
2 times a week

Yes, I have read the
facts on delivery. 		Pick-up at our store in Winter Park, FL - Locals Only (free of charge)
Full Service Delivery (Central Florida) to my home. Locals Only ($12 per week)
FedEx Overnight Delivery for Florida, Outside Local Delivery Area ($50 per week)
Outside of Florida FedEx Overnight Delivery ($100 per week)

Please select preferences for your meals:
No Dairy
No Shellfish
No Pepper
No Bell Peppers
No Mushrooms
 No Red Meat
No Raw Onion
No Fish
No Salmon
No Tuna
Non Spicy
  

Please list all food allergies:
Egg   Fish   Milk
Peanut   Shellfish   Soy
Tree Nut   Wheat    

How did you hear about us?
Gift Certificate or Promotional Code:
Locals Only: Your delivery driver (Central Florida) works hard and tips are always appreciated. If you would like to tip your driver, you may do so in cash or by filling in an amount here. per week
Yes, I have read and agree to the policies & procedures.

In A Glance • Intro to Organic • Diet Programs • How It Works
Privacy Policy • Terms and Conditions
 
Healthy Chef Creations®
1435 Howell Branch Road, Suite C, Winter Park, FL 32789 • 407-339-2433 • info@healthychefcreations.com
Call toll free 1-866-575-CHEF (2433)