Delivery Request

Delivery Request

If it fits, we fetch. If it doesn’t, we’ll hook up the trailer.
Name

First NameLast Name
What name is listed on the order?

SameOther
Email
example@example.com
Phone Number
Please enter a valid phone number.
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you need delivery from more than one place?

Yes
Don't worry if you don't see an option you need, just click the little chat bubble in the corner and you'll be able to talk with me directly. I can accommodate most requests.
What kind of delivery is this?*

Store PickupPharmacy Pickup (DOB & Copay req.)Custom Shopping (We shop for you)Other (person to person, furniture delivery, etc.)
Other Pickup Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
"Other" Pickup Information
If you have selected other as your pickup, please give a description of what you are needing picked up, approx. dimensions/weight and any other details that may be important.
What kind of deliveries do you need?*

Store PickupPharmacy Pickup (DOB & Copay req.)Custom Shopping (We shop for you)
Select a store for pickup
All pickups must be pre-ordered with the store and ready for pickup.
If ordering from Wilson's Building Supply, Cox Surplus, Wayne’s Feed, or Lewis Surplus, please notify the store that a third-party will be picking up on your behalf. Lowe's, Home Depot and Tractor supply require an email confirmation or order receipt for pickup.
Does your order contain...

Perishable GroceriesOversized item requiring trailer (e.g. mower, grill, fencing, kennel)More than 20 feed bags or mulchLumber over 8 feetLarge applianceNone of the aboveHigh-value (TV-Electronics, mower, power sports, ect.)Other
Pickup ready by

Hour Minutes

AM/PM Option
Select a Pharmacy
Date of Birth (Required for pharmacy pickup)

MonthDayYear
Date
A signature will be required for your order (Pharmacy or High-Value)

Myself or another adult will be availableI will not be available or I prefer contactless, a photo of the delivery is acceptableContact me for options
Select a store to shop from
Shopping orders require that you remain available for contact in-case of substitutions and you must wither pre-pay for the items or be ready to transfer funds digitally at checkout. If no payment is received, the order may be delayed or cancelled. Thank you for your understanding!
Reimbursement method for shopping costs?

Digital wallet (CashApp, PayPal, etc.)I’ll prepay or transfer before shoppingLet’s discuss first
Shopping orders require reimbursement before checkout unless pre-approved. We’ll reach out to confirm the requested items details any digital payment preferences.
Custom shopping requires contact for approval and availability for digital payment during checkout. Do you agree?

YesNo
Preferred Delivery Window
Order Number / Required Pickup Info
If there is a different name on the order other than the one above please also enter that here.
Confirmation Email / Receipt Upload

Upload helps us ensure smooth pickup and helps us double check items. If not uploaded, your order may be manually reviewed for approval.
Cancelof
Is there somewhere you prefer your order be placed, any directions where the GPS may be wrong, or any other information helpful to the driver (house/vehicle color, landmarks, etc.)
By checking this box, you agree to our Terms of Service*

I agree Terms of Service
Grocery_flag
Pharmacy_flag
Multi_stop_flag
Manual_review_flag
Oversized_flag
Trailer_required
Signature_required
Delivery_zone_fee
Pickup Coordinates
Delivery Coordinates
Distance in Miles
⚙️ Debug Output (Hidden Fields)

grocery_flag: {grocery_flag}

pharmacy_flag: {pharmacy_flag}

multi_stop_flag: {multi_stop_flag}

manual_review_flag: {manual_review_flag}

oversized_flag: {oversized_flag}

trailer_required: {trailer_required}

signature_required: {signature_required}

delivery_zone_fee: {delivery_zone_fee}

pickup coordinates: {pickup_coordinates}

delivery coordinates: {delivery_coordinates}

distance in miles: {distance_in_miles}
Should be Empty: