Healthcare Workers' Meals for Morale (restaurant responses)
The following survey will help identify and create a directory of restaurants that would like to donate meals to healthcare workers and critical staff (ex. janitorial/sanitation services) on the front lines of this pandemic.

This survey does not guarantee that your restaurant will be matched to a healthcare team, rather it is a directory to assist in connecting each other during this time of need.

After completion of this survey, you will then receive a confirmation email, and be able to edit your responses. Your responses will be added to a directory, you will be able to change your answers and remove your contact information once you have completed a donation so that more people do not reach out to you.
Email address *
Restaurant name
Primary contact name
Address/Location (Address, City, Zip)
Phone (xxx-xxx-xxxx)
# of meals your restaurant would be willing to provide (#)
Any # of meals that your organization can contribute is hugely appreciated! Teams are sometimes as small as 5 (example: overnight teams, janitorial staff on a floor, teams of ER physicians) and as large as 70+ (ICU floor physicians, nursing staff, coordinators, social work). Any and all donations would be appreciated.
Type of food or cuisine
Can you provide delivery?
Clear selection
Do you have a preference on which hospital/group this donation will go to?
Clear selection
Preferred date(s) for donation (e.g. 4/2/20)
Preferred time(s) for donation drop-off/pick-up (e.g. 12:00pm)
For returning restaurant owners ONLY who have completed their donation: Where did you complete your delivery? If you do not want to be contacted anymore, delete your phone # OR write DO NOT CONTACT here.
A copy of your responses will be emailed to the address you provided.
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