Meal Request Form

We are sorry you are not feeling well. While initially you may not want to eat, food and liquids can help in your recovery. Please provide us with the following information so that we can best assist you. Your meal request must be at least 2 hours in advance of the time your pick up time. Thank you and we hope you feel better.

Your meal card must be presented to the cashier. All alternate meals ordered due to illness will be deducted from your meal plan.

To speak to a manager, please call (804) 289-8522.

If you are submitting your request after 5pm or on a weekend, please call (804)289-8522 and speak to a manager to ensure your request was received.

Do you have a meal plan? *

Please answer a couple of questions so that we can better help with your nutrition needs:

Do you have access to a refrigerator? *
Do you have access to a Freezer? *
Do you have access to a Microwave? *
Do you have any food restrictions or food allergies? *
Select One: *
If you are ordering dinner, would you like a continental breakfast included?