Directions: Please answer the questions below by placing an X beside your best answer.  If you have difficulty, please ask a friend or family member to help you. If you have anything else you want us to know, please write it at the end of the last page or on a separate sheet of paper.

Here is a list of goals that home-delivered meals program try to meet. Please rate the program on each goal below.

If there are any foods you would like to see added to the menu or taken off the menu at your program, please list them below

If you receive information about nutrition, please check the best answers below to tell us how you use it.