Chicago Intake Form

Self-Registration Instructions

This registration process does require comfortably using technology/apps. Please carefully read the instructions below. If this does not seem like the right process for you, please go back and choose a Culinary Care support call.
To Self-Register:

1. Once you hit "submit" on this intake form you'll be directed to our registration form.

2. The registration form has two parts. You'll complete part 1 and then a verification email will be sent to you for you to complete part 2.

3. Check your email, click on the verification link, and complete part 2 (which is for grant/fundraising purposes, as we are an independent nonprofit funded by the community)

4. We approve all new registrations on Mondays, so please check your email on Monday for access to your account where you'll be able to order meals.

How To Order Meals:

1. Login to your account using the email and password you created during the self-registration.

2. Click the "Order Meals" button towards the top left of the page.

Note: You can always login to your account via our main website by clicking "Program Login" in the upper right.

**Important! We cannot provide same-day ordering.**

All meals must be ordered by 10 am CST the day before you need a meal OR by 10am Friday for Monday orders.

Schedule Your Welcome Call!

A welcome call is necessary to start receiving meals. Please find a time using the calendar below. We understand your treatment may fall before the next available date and we apologize for any inconvenience. Please choose the earliest available date. *If you need immediate assistance, please have your social worker contact us at meals@culinarycare.org.*
We're in Dallas! Our program currently delivers lunch, which means you'll need to be in infusion between 12 - 12:30 pm.

Yes, I'll be in infusion between 12 - 12:30pm.No, I'm typically there later.No, I'm typically there earlier.

Your pre-registration is almost complete!

Please click the "submit" button to officially complete your pre-registration and get connected with our team. Thank you for taking the time to complete this form. Please note that this is not a registration form. We use this form to ensure we can route you to the best answer/next step.
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Chicago Culinary Care Eligibility Form