How to Apply

ELIGIBILITY

Our services are available to any resident of Durham County who is homebound as a result of age, disability, or illness. Most recipients of meals live alone and are elderly, handicapped, malnourished, or otherwise unable to prepare food for themselves.

People of various incomes and ages may be eligible for meals. Meals on Wheels Durham does not discriminate on the basis of race, religion, creed, color, gender, disability, sexual orientation, or national origin.

APPLYING FOR SERVICES

For information about the meals and the cost of service, please visit our Frequently Asked Questions page.

Please complete and submit the online Application for Services form on our webpage or download the printable Application for Services form and we will contact you. (Adobe Acrobat Reader is required to access and download the printable Application form. Adobe Acrobat is available for free here.).

Please download, print, complete, and mail or fax the printable form. You can also drop it off at the office. We currently process application submissions on Tuesdays and Thursdays. Our contact information is located below and on our Contact Us webpage.

Meals on Wheels Durham
2522 Ross Road
Durham, NC 27703
Fax: 919-667-9458
Phone: 919-667-9424

Referral information may also be phoned into the Meals on Wheels office. The following information is required to submit a referral by phone:

Name of client
Address
Phone number
Date of birth
Medical diagnosis
Emergency contact information

Apply Now

Current Client Information
Nutritional Risk Assessment
Household Information
Additional Information
Complete

PROGRAM TYPE

Which program type are you interested in? Check all that apply.

Self Pay – NO WAITING LIST (Check, Credit Card, Food Stamps, Cash accepted. $5 per meal full price; $3.80 per meal using SNAP)

Cost-Free - Waiting List. No charge for meals, must meet qualifications.

Hospital Discharge Meals - APPLICATIONS FOR THIS PROGRAM MUST BE SUBMITTED BY HOSPITAL STAFF THROUGH NC CARE 360 PORTAL.

Non-HCCBG Bi-Annual Assessment - ACTIVE CLIENTS ONLY who received an assessment from volunteer.

The Hospital Discharge Meals Pilot Program is a partnership with Meals on Wheels NC and UNITE US NC CARE 360. It is a pilot aimed to evaluate the effectiveness of providing healthy meals to high-risk adults (60+ y/o) after hospital discharge to reduce health complications and hospital readmissions through proper nutrition.

ONLY REFERRALS SENT TO THIS PROGRAM THROUGH NC CARE 360 WILL BE ACCEPTED AT THIS TIME. WE APOLOGIZE FOR ANY INCONVENIENCE THIS MAY CAUSE.

When will patient be home from rehab / the hospital?

*DEPENDS ON QUALIFICATIONS & AVAILABILITY

NEED FOR SERVICE

What is your need for our services? Check all that apply.

Homebound

Living alone

Unable to cook

Unable to shop

CLIENT INFORMATION

First name:

Last name:

Street address:

Apartment Number

Apartment Name

City:

State:

Zip code:

My residential address is:

Rural

Urban

Phone number:

Email address (if any):

Would you like to also receive email or text message notifications from Meals on Wheels?

Gender

Marital Status

Date of birth:

Race

Primary Language

Are you a veteran?

Which of the following best describes your current health or medical insurance coverage. Select all that apply.

Medicaid

Medicare

Private

Not Insured

Prefer not to answer

Other

Do you receive SNAP benefits?

Yes

Do you have a food allergy?

Yes

Please list food allergen(s)

Do you have a disability or impairment?

The Americans with Disabilities Act (ADA) defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activity. This includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability.

Please specify each impairment you may experience:

Questions	None	Some	Total
Hearing	None	Some	Total
Sight	None	Some	Total
Speech	None	Some	Total
Taste	None	Some	Total
Smell	None	Some	Total
Cognitive Difficulties	None	Some	Total

Do you use the following mobility aids? Select all that apply.

Cane

Walker

Wheelchair

Non-ambulatory

Does not use mobility aid

Prefer Not to Answer

Additional Information (if any)

Do you belong to a church / synagogue / mosque / faith community?

Yes

If so, please let us know the name of your faith community.

How did you hear about Meals on Wheels Durham?

Other

×*Meals on Wheels Durham processes meal service applications on Tuesdays and Thursdays.*

ELIGIBILITY

APPLYING FOR SERVICES

Apply Now

*ONLY REFERRALS SENT TO THIS PROGRAM THROUGH NC CARE 360 WILL BE ACCEPTED AT THIS TIME. WE APOLOGIZE FOR ANY INCONVENIENCE THIS MAY CAUSE.*

ONLY REFERRALS SENT TO THIS PROGRAM THROUGH NC CARE 360 WILL BE ACCEPTED AT THIS TIME. WE APOLOGIZE FOR ANY INCONVENIENCE THIS MAY CAUSE.