Online Meal Request

Meals on Wheels are nutritious meals that are delivered Monday through Thursday between 10 a.m. and 2 p.m.

We serve seniors who live in Multnomah and Washington counties in Oregon and Clark County in Washington.
The cost of each meal is $10.50. Participants are asked to contribute to the cost of the meal.
Participants must be at home to receive meals.
Meals on Wheels People volunteers have received background checks and training prior to delivery.
Please request meals when you are ready to receive them.

How to Request Meals on Wheels Service:

Complete the form below. Meals on Wheels People staff will call you to review your eligibility in the program. To discuss your eligibility, please call 503.953.8111 or toll-free 866.788.6325

NOTE: To request a call to discuss the home-delivered meals program, please fill out the form below and we will contact you as soon as possible.

IMPORTANT: IN ORDER TO RECEIVE MEALS, Participants must be 60 years or older or turn 60 YEARS OF AGE within the next 6 months.

*required field

Your First Name:

Your Last Name:

Your Phone Number:

Your Email:

Your Relationship to Client/Recipient:

First Name:

Middle Initial:

Last Name:

Date of Birth

Address:

Apt/Unit Number:

Apartment Complex (if applicable):

Phone:

Alternate Phone:

City:

State:

Zip:

Primary Language (if other than English):

Does the participant know meals are being requested?
yesno

Does the participant have a Medicaid / COPES case manager?
yesno

Name of Case Manager:

Phone Number of Case Manager:

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Contact Phone:

Relationship to Participant: