LSS Meals on Wheels Sign Up

Meal Recipient Information

Delivery is available Monday through Friday. Delivery is available to residents living in Long Prairie, Browerville, Clarissa, Eagle Bend, Bertha, Wadena, Verndale, and Staples.

Name

Date of birth

Phone number

Email

Frequency

Pay source

PMI/Member #

Are you placing an order for someone else?

If so, please respond to the questions below.

Your name

Your phone number

Meal Information

Requested start date

We can generally begin service within three business days of receiving a completed application.

Food allergies

Please list all food allergies, if applicable.

Delivery Instructions

Other Information

Reason/cause for needing meals

Meal Recipient Demographics

LSS Meals does not discriminate on the basis of gender identity or race. We use gender and race data to track the effectiveness of our program. Your answers to the following questions are optional and will not affect your ability to receive services.

Gender

Race

Questions: Call us toll-free at 800.488.4146 during office hours Monday through Friday, 8:00 a.m. - 4:30 p.m.