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Are you on a wheat-free or gluten-free diet? Yes No
Do you have one of the following diseases?
| Celiac | Attention Deficit Disorder | Autism |
| Chronic Fatigue | Fibromyalgia | None |
Are you allergic to any of these flours?
Corn Flour Rice Flours
Do you have an automatic bread machine? Yes No
How often do you order by mail?
What products do you purchase by mail? Baking Supplies Prepared Mixes Cookbooks
Are you looking for any particular product?
What brand of gluten-free mixes do you purchase most often?
Authentic Foods Arrowhead Mills Gluten-Free Pantry Energ-Foods Pamela's Mrs. Robens
Dietary Specialties Menu Direct
Have you used Authentic Foods products? Yes No
What products from Authentic Foods interest you the most?
Gluten-Free Flours Pancake & Baking Mix Cake Mixes Bread Mixes Natural Flavors Cookbooks
Sender's e-mail address:
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