You are here: Home / My Glutafin Registration
  • A
  • A
  • Font Size


Love Food the food club from Glutafin




















Gender:


How were you diagnosed?:
 

:


:
 

My diet must be:

Registered on behalf of a child:
 

What cuisines do you enjoy? (please tick all that apply):
 



On a scale of 1-6, how would you say the majority of your meals are made?:
 



What type of bread do you prefer?:
 


If you get any of these products on prescription please place how many per month you get for the correct brand:
Glutafin Juvela Other brand
Fresh Rolls:
Pasta:
Long Life Breads:
Biscuits:
Long Life Rolls:
Fresh Bread:
Pizza Bases:
Crackers & Crispbreads:
White Mix:
Fibre Mix:
Other type Mix:

Which of the following supermarkets do you shop in most often?:

Co-operative



Glutafin would like to contact you from time to time with news and promotions. We will not pass on your details to any third parties. Please tick the boxes below if you do not want us to contact you using this method.

 


If you would prefer not to receive information from our sister & partner brand Dietary Specials, please tell us by ticking the box

Where did you hear about Love Food?
 















Join Glutafin Coeliac and others on facebook

Follow Glutafin on Twitter for the latest tweets - twitter.com/glutafin
Bookmark and Share Glutafin