Ordering

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* Indicates required field

Name *

First

Last

Address *

City *

Zip *

Phone Number *

Case Manager / Unknown / None *

Number of Meals Authorized / Requested *

Enter the number of each type of meal you would like and press submit, its that simple! Once the order has been received a customer service representative will contact you to confirm your order and delivery date.

Menu Cycle 1

Menu 1 Chicken ala King *

Menu 2 Breakfast Sandwich *

Menu 3 Lasagna *

Menu 4 Fried Chicken Leg *

Menu 5 Sliced Beef *

Menu Cycle 2

Meal Option 6 Chicken Breast *

Meal Option 7 Chicken Alfredo *

Meal Option 8 Meat Loaf *

Meal Option 9 Sausage Gravy and Biscuit *

Meal Option 10 Salisbury Steak *

Menu Cycle 3

Meal Option 11 Shredded Chicken with Biscuits *

Meal Option 12 BBQ Riblet *

Meal Option 13 Chicken Parmesan *

Meal Option 14 Cheese Omelet *

Meal Option 15 French Toast *

Milk Options Choose One *

Fresh Milk Dry Milk No Milk

Comments *

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