NYS FAM Coalition - Food Supplier Survey

  • NYS FAM Coalition - Food Supplier Survey

    for Food Banks/Private Wholesalers/Food Suppliers

  • Are you a wholesaler/food supplier for food as medicine interventions such as:

    • Medically Tailored or Clinically Appropriate Home Delivered Meals
    • Medically Tailored or Nutritionally Appropriate Food Prescriptions
    • Fresh Produce and Non-Perishable Groceries (Pantry Stocking)?

    We are building a resource list of food banks/private wholesalers/food suppliers to share with the Coalition.

    Please respond to this survey to be added to our Coalition Food Supplier resource list.

  • Format: (000) 000-0000.
  • 1. Please select the NYS Counties in which you provide services (select all that apply)*
  • 2. For which of the following services are you able to supply food?*
  • 2A. Do you offer direct to home delivery?
  • 2B. Do you offer wholesale delivery to FAM providers?
  • 3. Please indicate the dietary accommodations you are able to provide (check all that apply)*
  • 4. What is your service frequency? (if you offer multiple service frequencies, select all that apply)*
  • 5. Do you offer in-person services, delivery services, or both?*
  • 6. What percentage of your seasonal food is NYS grown/produced or grown/produced within a 400-mile radius?*
  • Are you certified in NYS as a Minority or Women-Owned Business Enterprise? (MWBE)*
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