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<br />Does meals on wheels help you to continue living at home? _____ Yes ______ <br />No <br /> <br />As a result of receiving meals on wheels do you feel better? _____ Yes ______ No <br />In the last year, have you worried that you would not have enough money for food? <br />____Yes ____No <br />In the last year, did you have a problem having food last and you did not have enough <br />money to get more food? ___Yes ____No <br /> <br />Do you prefer your meals ____ Chilled, for you to microwave? ____or Hot? <br /> <br />What is your favorite part of the meal? ___Soup/Salad ___Entree ___Fruit ___Sweet <br />desserts <br /> <br />Please tell us why you are getting meals? (check all that apply) ____ <br />Illness/disability/fall <br />____ Low income _____ Cannot cook or shop _____ Recent discharge from health facility <br /> <br /> <br />279