Safe Food Entry Template
FOOD NAME:
CATEGORY:
- Snack
- Meal
- Drink
- Emergency Food
- Comfort Food
- Recovery Food
- Hyperfixation Food
- Low Spoon Food
- Dopamine Food
- Sensory Safe Food
- Other: ____________
TEXTURE SAFETY:
1 2 3 4 5 6 7 8 9 10
PREDICTABILITY:
1 2 3 4 5 6 7 8 9 10
EXECUTIVE FUNCTION FRIENDLINESS:
1 2 3 4 5 6 7 8 9 10
EMOTIONAL RESTORATION:
1 2 3 4 5 6 7 8 9 10
SENSORY STABILITY:
1 2 3 4 5 6 7 8 9 10
WHY IS THIS FOOD SAFE?
TEXTURE DESCRIPTION:
(Check all that apply)
- Crunchy
- Soft
- Uniform
- Crispy
- Smooth
- Warm
- Cold
- Dry
- Wet
- Chewy
- Predictable
- Non-mushy
- Gentle
- Low smell
- Other: ____________
WHAT SITUATIONS IS THIS FOOD GOOD FOR?
- Burnout
- Panic
- Shutdown
- Low appetite
- Sensory overload
- Executive dysfunction
- Depression
- Recovery day
- Social exhaustion
- Illness
- PMS/PMDD
- Anxiety
- Other: ____________
