|
Forms
Social Service Providers:
You must have you client
call us directly or sign a HIPAA confidentiality release form in
order for our staff to contact them or you to conduct a meal delivery
intake. Please send your contact information along with this completed
form and fax it to 212-294-8198.
HIPAA
Form Letter (pdf)
Home Delivered Meal
Eligibility Letter
This eligibility form
letter must be completed and sent back to our offices within 10
business days of completing a meal intake.
Eligibility
Form Letter (pdf)
Client
Referral Form
Things
to Keep in mind when referring or becoming a client (pdf)
|