God's Love We Deliver
166 Avenue of the Americas
New York, NY 10013
Listed below are the various forms that can be used to become a client, confirm that we can discuss referral information and confirm that someone is eligible for our programs. Please note: Adobe® Reader® is needed to view these forms.
Please note that God’s Love referrals should include the new ICD-10 codes on our medical referral form as of December 1st 2015.
Please click below for the full packet to enroll or refer a loved one, client or patient to our Home Delivered Meal Program. It includes the Client referral Form, HIPAA Release Form, medial Referral Form and new client forms. Please note proof of income and proof of residence required for HIV/AIDS diagnoses. Please note that Health Proxy or Power of Attorney is needed for clients with dementia diagnoses. See below for examples and health proxy form.
God's Love We Deliver requires proof of income and proof of residence required for HIV/AIDS diagnoses. Click on "download form" for examples.
Health Proxy or Power of Attorney is needed for clients with dementia diagnoses.
THIS PROGRAM IS VERY SMALL. Please contact Megan Slate at firstname.lastname@example.org regarding openings.
If I'm not home at the time of my delivery, will you leave my food with my doorman, front desk, neighbor, superintendent or on my doorknob?
Is my home health aide eligible for your services?