Client Application Form





Client Information










HotFrozenBoth




Medical Information








Emergency Contacts

I give consent to Meals on Wheels to call the following emergency contacts:













Previous KnowledgeFamily/friend/volunteerAging in place coordinatorWebsiteHospitalOther:

If other, please specify



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Did you know?

In 2013-14, a total of 68,731 hot meals and 38,372 frozen meals were served to 1,490 clients with the help of 505 volunteers.