Select a shaded field to edit it. Verify every declaration before using the menu. Then print or save as PDF. Edits are not retained in this file; keep the underlying ingredient records separately.
Dish / variation: [name] · Location: [location]
Recipe version: [version] · Reviewer: [name] · Date: [date]
Complete one worksheet for each dish and variation. Every cell starts as Unknown. Assess ingredients, supplier warnings, and kitchen cross-contact separately.
| Allergen | Ingredient presence | Supplier warning | Kitchen cross-contact | Evidence / controls / species |
|---|---|---|---|---|
| Milk | Unknown | Unknown | Unknown | [Reference] |
| Egg | Unknown | Unknown | Unknown | [Reference] |
| Fish | Unknown | Unknown | Unknown | [Reference] |
| Crustacean shellfish | Unknown | Unknown | Unknown | [Reference] |
| Tree nuts | Unknown | Unknown | Unknown | [Reference] |
| Peanut | Unknown | Unknown | Unknown | [Reference] |
| Wheat | Unknown | Unknown | Unknown | [Reference] |
| Soy | Unknown | Unknown | Unknown | [Reference] |
| Sesame | Unknown | Unknown | Unknown | [Reference] |
Ingredients: Contains / Not used after review / Unknown.
Supplier: Warning identified / No warning on reviewed label / Unknown.
Kitchen: Risk identified after controls / No identified risk after assessment / Unknown.
“No warning on reviewed label” does not establish that supplier cross-contact is absent. Investigate unresolved supplier risks. “No identified risk after assessment” is not a safety certification.
Supplier labels and sub-ingredients reviewed: [references]
Equipment, oil, storage, utensils, and service reviewed; controls used: [details]
Other allergens and gluten assessment, if applicable: [details]
Approved menu wording (Contains / May contain / Not yet verified): [wording]
Approved by: [name] · Date: [date] · Next review: [date or trigger]
Review the record after any recipe, supplier, or preparation change, before serving the dish. Update the menu and staff record together.