Home Delivered Meal Referral Form

The Home Delivered Meal Program, commonly referred to as "Meals on Wheels" can provide meals at home for older adults (over the age of sixty) who are unable to cook for themselves; have no one to cook for them or are unable to attend a senior congregate meal site.

Please complete the KIPDA Intake Form if you, or a senior you assist, could benefit from Louisville Metro Meals on Wheels/Home Delivered Meals.  This intake form will take approximately ten minutes to complete. KIPDA staff will then contact you within two business days.  

Home Delivered Meal Client Assessment (New Client):

• Please complete KIPDA Intake Form
• Completed form allows a staff member with KIPDA's ADRC (Aging and Disability Resource Center) to contact the prospective client, complete the necessary assessment, and schedule a home visit.
• Clients unable to complete digital forms should contact ADRC at 502.266.5571.