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



captcha

Did you know?

In the Fall of 1968, Island Lodge (now Garry J. Armstrong Centre) offered to provide 24 meals each day and now has the distinction of being the longest serving meal provider.