Medication & Grocery Delivery Request Form
Our volunteer delivery drivers are able to pick up your groceries and/or your medications from your preferred grocery store/pharmacy and deliver them on the same day for free.

Without access to reliable transportation and the risk of health, it is unsafe and unpractical for some seniors to get their own groceries or medication - especially if they do not have anyone to shop or pick up for them.

Please complete this form after you have ordered your prescriptions and/or groceries as you will require order/prescription order information to complete this form

If you have issues or have difficulty completing the form, please call us at (289) 482-0477.
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