ReFRESH Grocery Distribution

ReFRESH Grocery Distribution
Groceries are picked up from:

Childhood Cancer Foundation Office

330 Alabama Street, Suite K, Redlands, CA 92373
Appointment Information
Select your Preferred Pick-up Time
Grocery pick-up is at: 330 Alabama Street, Suite K, Redlands, CA 92373
Full Name

First NameLast Name
E-mail
example@example.com
Cell Number
Format: (000) 000-0000.
Provide additional information
Patient's Full Name

First NameLast Name
What is your zip code?
Preference in food?
How many children in the household? Ages birth - 17 years.
How many Adults in the household? Ages 18 - 54 years.
How many Seniors in the household? Ages 55+ years.
How many Veterans (US Military) in the household?
Should be Empty:

Appointment Information