Request a Free Grocery Delivery
Here is the form to request a grocery delivery. We will usually fulfill your order within 1-2 days. If you would like to send us pictures of the items, do so at pdxconcierge2020@gmail.com or 971-347-7778. Tips are optional. Thank You!
What is your Name? *
What is Your Phone Number ? (cell preferred, please specify if it's a landline) *
What is your email address? *
What is your birthday? Please just include the day and month, no need for the year. If you’re uncomfortable with providing it that’s fine, just leave it blank
What is your grocery list? (including the store). Please be as detailed as you can, and if possible, separate each item with a carriage return (a new line) *
Do You Have a Preference for the Date of Delivery? (e.g. I would like the delivery done BY Monday, June 1 OR I would like the delivery done ON Monday June 1) *
What is your address? Please include apartment number and additional notes if necessary (e.g. orange house, left side, etc). *
How did you hear about us?
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Acknowledgement: PDX Concierge is volunteer-based service and intends to help the community. We hold your private information in high regard and will maintain confidentiality. We are not liable for any spoiled foods or similar concerns and have the permission to provide our volunteers with your personal information to deliver groceries. *
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