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Special Diet Order Form

How does it work

-Fill out the Form

-Select one Sandwich and any 3 sides items (including beverages).

-Submit the Form up until midnight for the following day (1 order per request).

-Pick up your meal at location selected

-Items may be picked up in Wandas from 10:30 am - Closing

-Items may be picked up at Brisco's from 10:30am - until closing

-Your card will be charged at the time of the order

-Food not picked up on the scheduled day will be discarded

-Food is intended to be eaten within 30 minutes of pick-up unless stored in refrigeration. When stored in refrigeration food should be eaten within 48 hours of pick up.

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08-29-2015


Special Needs (Check boxes that apply)








Type of Meal



Special Diet Sandwich (Built to order)

Bread (Choose 1)









Protein (Choose 1)







Cheese (Choose 1, Optional)


Extras (Choose as many as you like)








Side Items (Choose 3)
















Special Diet Entrée (packaged in a microwaveable dish)


Protein (Choose 1)





Choose 1





Choose 1





Choose 2










Choose 1