Dietary & Allergy Questionnaire

To ensure the best possible dining experience in Japan, many restaurants require detailed dietary information well in advance. Please answer carefully and as specifically as possible.

Japanese fine dining restaurants often prepare ingredients and menus specifically for each guest.
Last-minute changes may not be possible once preparations have begun.
Some severe allergies or strict dietary requirements may not be fully accommodatable in traditional Japanese kitchens.
“Dislike” and “medical or religious restriction” are treated very differently in Japan — please be precise.

Guest Information

One form per guest. If multiple guests are travelling, each adult (and the guardian of any child) should complete a separate response.

Full name *

Please enter your full name.

Email *

Please enter a valid email address.

Allergies & Ingredients to Avoid

For each ingredient, indicate the type of restriction. Leave items unmarked if there is no restriction at all.

Seafood

For religious fish restrictions, please specify in Section 6 whether only scaled fish is permitted.

Meat & Poultry

Gluten & Soy Sauce

Most soy sauce in Japan contains wheat. Gluten-free tamari is available on request at high-end restaurants if specified well in advance.

Do you require gluten-free soy sauce?

Yes No

Please specify the reason

Celiac disease Gluten intolerance Preference only

Nuts, Sesame & Oils

Sesame in particular is widely used in Japanese cuisine. If you have any restriction here, please be precise.

Severity

For any restriction above, please indicate the severity.

Airborne / contact Ingestion only Mild intolerance Preference only

Additional Ingredients

Please list any additional ingredients or preparations you prefer not to eat — for example uni (sea urchin), organ meats, mushrooms, natto, or particular textures.

Cross-Contamination

In intimate counter kitchens, complete separation can be challenging. Please indicate the level of care required.

Minor contact / cross-contamination is acceptable Cross-contamination should be minimised where possible Strict separation required for medical reasons

Medications & Appetite

Some medications significantly affect appetite, portion capacity, or digestion. Sharing this in advance helps chefs plan course sizes and richness appropriately. All answers remain confidential and are shared only with venues on a need-to-know basis.

Are you currently taking a GLP-1 medication or similar appetite-affecting medication?

Examples include Ozempic, Wegovy, Mounjaro, Zepbound, Saxenda, Rybelsus, or comparable medications.

No Yes Prefer not to say

A few follow-up details

These help chefs adjust portion sizes and course pacing. You may skip any question you prefer not to answer.

Which medication? — optional

Typical portion capacity

Full portions comfortable Reduced portions preferred Very small portions only

Any recent nausea or GI sensitivity with rich, fatty, or heavy foods?

Yes No

Anything else the chef should know? — optional

Important Acknowledgment

Before submitting, please confirm you have read and understood the operational notes.

A note on fragrance

At omakase counters, please avoid all perfume, cologne, scented hair products, and strongly scented laundry detergents on the day of dining. This is the single most important etiquette point at high-end Japanese restaurants.

★ Required to submit

I understand that Japanese fine dining restaurants prepare bespoke menus in advance, that last-minute changes may not be possible, and that the answers I have provided will be shared with chefs and restaurants in good faith.

Please acknowledge before submitting.

Ready to send

When you submit, your responses will be sent to Happy Camper.

Dietary & AllergyQuestionnaire