Shock Box Order Form
What is your Shock Box order?
Minimum of 4 orders, you may select multiple boxes
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Tex-Mex Shock Box - C. 48g, F. 23g, P. 11g 3 oz chicken 2 oz guac 2 oz salsa 2 oz block cheese 2 oz red bell peppers
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Paleo Shock Box - C. 19g, F. 33g, P. 28g 3 oz chicken 1 oz almonds 1 small apple (4 oz) 1 boiled egg 2 oz Primal Kitchen Honey Mustard
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Vegetarian Shock Box - C. 26g, F. 15g, P. 17g 8 slices melba toast (.85 oz) 1 boiled egg 2 oz seasonal fruit 1.5 oz mozzarella 2 oz classic hummus
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Keto Shock Box - C. 18g, F. 54g, P. 39g 3 oz chicken 2 oz raw zucchini strips 2 oz block cheese 2 oz Chosen Food chipotle ranch 1 oz Keto cookie dough 1 boiled egg
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Mediterranean Shock Box - C. 35g, F. 28g, P. 25g 3 oz chicken 10 pita crackers (.85 oz) 3 oz cucumbers 1 oz kalamata olives 2 oz jalapeno hummus 2 oz grape tomatoes .5 oz feta
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Chicken Salad Shock Box - C. 48g, F. 23g, P. 11g 3 oz chicken .5 oz celery .5 oz walnuts .5 oz dried fruit 4 oz red grapes 1 oz wheat thins 1 boiled egg
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Jack-Snack Box - C. 68g, F. 45g, P. 10g 2 oz whole grain pasta .5 oz shredded parmesan cheese .5 oz fresh basil 1 oz ranch dressing 5 oz fresh spinach 2 oz strawberries 1 giant marshmallow 1/3 Hershey bar (.40 oz) 1/2 graham cracker (.25 oz) 1/2 tbs olive oil
$8.00
$
8.00
Quantity
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Subtotal
$0.00
$
0.00
Tax
$0.00
$
0.00
Total
$0.00
$
0.00
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