Chronic Cooks Meal Delivery Sign Up Form

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Chronic Cooks wants to help those with Long Covid and other chronic illnesses fuel their healing with nutritious, home-cooked meals. That said, at this time, anyone in the Austin TX area can sign up to receive a meal.

Filling out this form puts you on the list to receive one meal box whenever we have availability. Each box will contain two large servings. If you would like to sign up for more than one box per delivery please contact us directly (longcovidcollective@gamil.com) to make that request.

Please note that while we are testing the feasibility of accommodating special dietary needs, we cannot yet guarantee an allergen-free prep area.

Email *

Delivery Address
*

Phone number for coordinating delivery on the day? *

Are you a member of the Long Covid Collective? (If not, you can join here) Members get priority in receiving services from the Collective.
You do not need to be a member to receive a meal

Yes

Do you have long covid or another chronic illness/disability that makes it difficult for you to cook? *

Yes

Do you want contactless delivery? All delivery drivers will wear a mask during their delivery regardless of what you select.

Yes

Please select your meal choices - you will receive one box with two servings

Flexible Meal - focus on whole grains, lean proteins, healthy fats, nutrient density, mostly low-histamine, and organic produce when possible.

Strict Meal - same as above, except vegan, much more focus on being low-histamine, and does not contain any of the FDA's 9 major food allergens (milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, sesame)

**we will do our best, but cannot guarantee an allergen free prep environment**

Both servings Flexible Option

Both servings Strict Option

One serving Flexible, one serving Strict

I acknowledge that I have read and agree to the Long Covid Collective's Chronic Cooks Liability Waiver Form.

Read the form here.

Checking the box and filling in your name bellow constitutes signing said Liability Waiver Form.

I have read and agree to sign the LCC's Chronic Cooks Liability Waiver form

Required

Type in full name for signature
*

Any thing else you wish us to know at this time?

A copy of your responses will be emailed to the address you provided.

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