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MEAL SUPPORT ELIGIBILITY QUESTIONNAIRE

Tell Us What Kind of Help You Need

Complete this short questionnaire for yourself or someone you are helping. We use your answers to understand food access, daily-living needs, and possible meal-support options.

Questions? Call 301-414-FOOD (3663) Email info@food4md.org

Food 4 Maryland
Meal Support Eligibility Questionnaire

Tell Us What Kind of Help You Need

Complete this short questionnaire for yourself or someone you are helping. We use your answers to understand food access, daily-living needs, and possible meal-support options.

Questions? Call 301-414-3663 Email info@food4md.org
1 About the Person Who Needs Meals

Please provide the best contact information for the person who needs assistance. Food 4 Maryland is currently accepting questionnaires only from the Maryland counties listed below.

Who is completing this questionnaire? *
What is the best way to contact you? *
2 Age, Household, and Income

We do not ask for an exact income amount. The income question is only an initial screening question and does not by itself guarantee or deny services.

Is the person who needs meals age 60 or older? *
How many people live in the household, including the person who needs meals? *
2026 income amounts used for this initial screen
1-person household$15,960 per year or less
2-person household$21,640 combined per year or less
3-person household$27,320 combined per year or less
4-person household$33,000 combined per year or less
5-person household$38,680 combined per year or less
6+ person household$44,360 for 6 people; add $5,680 for each additional person
These are the 2026 HHS poverty guidelines that apply in Maryland. We do not ask you to enter an exact income. This question is only an initial financial-need screen and does not guarantee or deny services.
Using the amount above that matches the household size, is the household’s total annual income before taxes at or below that amount? *
3 Shopping, Cooking, and Daily-Living Needs

These questions help us understand whether getting or preparing food is difficult.

Do you have difficulty shopping for groceries because of mobility, health, transportation, or another limitation? *
Do you have difficulty preparing or cooking meals safely? *
Do you need help standing, lifting groceries, using the stove, or moving around the kitchen? *
Is it difficult for you to leave home without help? *
Do you sometimes skip meals, eat less than you should, or worry that food will run out? *
Are you interested in home-delivered meals? *
Does anyone else in the household also need meal assistance? *
4 Anything Else We Should Know?

Your answers are sent directly to info@food4md.org.

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