Client Name *

First Name

Last Name

Client Signature (Type Your Full Name)

First Name

Last Name

Date *

MM

DD

YYYY

✅ Client Agreement *

Please check each box to indicate your understanding and agreement: Then list the following as individual options within that checkbox field:

I understand that Meals With A Friend is not a medical or home health service.

I agree to treat volunteers with respect and kindness during each visit.

I understand that volunteers are not responsible for personal care, transportation, errands, or household tasks.

I understand that meals may be picked up from approved locations, and are not prepared in volunteer homes unless otherwise stated and approved.

I understand that Meals With A Friend cannot guarantee specific visit times, but will do our best to match availability and preferences.

I agree to communicate any schedule changes, concerns, or feedback to MWAF staff as soon as possible.

I give permission for MWAF to keep basic contact and service records to support and improve my experience.