By submitting an inquiry form, you authorize Mom’s Meals to share your contact information and the details you provide with the applicable health plan, Social Care Network, or locally contracted agency for eligibility screening, care coordination, and referral support.
This may include direct phone or email outreach from a contracted agency. You also consent to receive email and/or SMS communications from Mom’s Meals. Submission of this form does not guarantee eligibility or enrollment. Final eligibility decisions and selection of service providers are made by the applicable agency.
This authorization is voluntary and is not required to receive benefits. It will expire when screening or referral activities are complete or one year from the date of submission, whichever occurs first. You may revoke this authorization at any time in writing.
View our full Mom's Meals Terms & Conditions for more information.
