Kim's Krew Referrals

If you are in need of assistance DO NOT fill out the form above. The form is indented for Kim's Krew referral agencies and their staff members. Please call the pantry at 941-792-0993.

Kim’s Krew is a referral only agency, ensuring care reaches those most in need. By working alongside healthcare providers, social service agencies, and local organizations, we aim to bridge short-term gaps in food access with dignity, compassion, and timely support. In addition to deliveries, our volunteers aim to offer compassionate navigation to help clients connect with longer-term community resources towards the next step of stability and self-sufficiency.

Please feel our form to the best of your ablity and one of Kim's Krew volunteers navigator will reach out.

Thank you!

Kim's Krew Health Agency Referral Partner*

Referral Staff Name*

First NameLast Name

Referral Staff Phone Number

Please enter a valid phone number.

Referral Staff Email*

example@example.com

Client's Name*

First NameLast Name

If you are in need of assistance DO NOT fill out the form above. The form is indented for Kim's Krew referral agencies and their staff members. Please call the pantry at 941-792-0993.

Client's Phone Number*

Please enter a valid phone number.

Client's Alt. Phone Number

Please enter a valid phone number.

To qualify for Kim’s Krew services, individuals and their household must meet ALL of the following criteria, please select all that apply to client being referred:*

1. Currently Experiencing a Health-Related Crisis: The client is experiencing a short-term or chronic health crisis either physically or mentally that limits their ability to access food sources safely.2. Experiencing Barriers to Food Sources: The client is unable to access food sources such as grocery stores, traditional food pantries, etc, due to health-related issues that fulfill their dietary needs.3. Actively Engaging with a Kim's Krew Referral Partner: The client must be actively working with a Kim's Krew Referral Partner Manatee County EMS, MCR Health, Meals on Wheels or a health agency with case management support. Verification or referral from partner’s case management support is required, this form counts as referral.4. Understanding Kim’s Krew is Temporary Support: The client understands Kim’s Krew services are designed to provide up to 30 days of food and essential items delivered. Extensions are not guaranteed and may be asked to re-apply.

Does the client strongly agree with the statement "I/we do not have food for the next 3 days"?

YesNo

Comments

If you are in need of assistance DO NOT fill out the form above. The form is indented for Kim's Krew referral agencies and their staff members. Please call the pantry at 941-792-0993.