Personal Information

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Patient Information

Tell us about yourself so that we can develop a meal program that is tailored to your specific preferences and needs.

  • First Name:
    *
  • Last Name:
    *
  • Date of Birth:
  • Gender:
    *
  • Phone:
    *

Food Restrictions

Meals to Heal meals may contain or may be prepared in a facility that also prepares milk, eggs, fish, crustacean, shellfish, tree nuts, peanuts, wheat, soybeans and other common food allergens. If you may be allergic to such substances, Meals to Heal is not an appropriate food program for your dietary needs. Please read the full disclaimer regarding food allergens.

STATEMENT REGARDING FOOD ALLERGENS

The eight most common food allergens are as follows: milk, eggs, peanuts, tree nuts (such as almonds, cashews, walnuts), fish (like bass, cod, flounder), shellfish (including crab, lobster, shrimp), soy and wheat.  If you are allergic to any of these foods, please be aware that we prepare foods in our kitchens using these ingredients, and while we make every effort not to do so, we cannot guarantee that there will not be any cross contamination with our other meals.

Food allergy reactions can range from mild to severe. If you have food allergies, we caution you to exercise extreme caution when ordering our home delivery meals. If your allergy is moderate to severe we cannot recommend our home delivery meals for you.

Individuals with allergies or other special medical conditions are urged to take extra precautions. Meals to Heal labels most products with the ingredients contained within.  If you have adverse reactions to specific foods, it is your responsibility to be sure that you do not eat these foods.  Meals to Heal cannot be held liable for any damages related to allergies or other medical conditions.

If you have any questions regarding food allergens in our home delivery meals please contact our customer service department at  888-721-1041.