Eligibility

For residents within the Hyde Park Central School District or the village of Rhinebeck, delivered meals……

Are available on a continuing basis for mature adults who find it hard to plan, shop, and prepare nutritious meals for themselves.
Are available on a short term basis for people of any age recovering from surgery or other temporary conditions.

Referrals for service are made by phone or online (see below). Sources for referrals are varied: the potential client, neighbor, relative, friend, clergy, or a related agency serving the community.

PLEASE TAKE NOTICE

We have had reports that the application form below does not submit properly, possibly due to certain internet browser issues. If you are not able to submit your application successfully, please email mealsonwheelshp@gmail.com and a representative will assist you with your information. (Our tech support is looking into this matter. Thank you for your patience.)

Application

← Back

Thank you for your response. ✨

Client's Name

Marital Status

Gender

Male Female

Date of Birth (MM/DD/YYYY)

Phone Number (include area code)

Address Line 1

Town

Zip Code

Nearest Cross Road (for deliveries)

Is This a New or Re-Opened Application?

Comment

Referral Name

Referral Agency

Referral Phone Number

Please enter Referral email:

Is the Client Aware of the Call?

Why Did You Make the Referral?

Please List any Special Circumstances:

Emergency Contact Name

Emergency Contact Phone (including area code)

Emergency Contact Address

Please enter Contact email:

Emergency Contact Relationship with Client

Meals On Wheels of Greater Hyde Park

Apply For Meals

Eligibility

PLEASE TAKE NOTICE

Application

Thank you for your response. ✨

Like this:

Leave a ReplyCancel reply

Eligibility

PLEASE TAKE NOTICE

Application

Thank you for your response. ✨

Share this:

Like this:

Leave a ReplyCancel reply