Answer these questions to get personalized help with food assistance programs and resources.

Food assistance and nutrition services professional resources and assistance programs

Do you have enough food to eat right now?

Yes
No

In the past 12 months, we worried whether our food would run out before we got money to buy more.

Often true
Sometimes true
Never true

In the past 12 months, the food we bought did not last and we did not have money to get more.

Often true
Sometimes true
Never true

These two screening questions are aligned with the CMS Accountable Health Communities food-needs screen. They do not determine eligibility or make a diagnosis.

Are you currently enrolled in any food-assistance program? (Check all that apply)

Do you have any dietary restrictions (e.g., diabetic, vegetarian)?

Yes
No

Please describe your dietary restrictions:

💡 Tip: Click the microphone icon to speak your dietary restrictions instead of typing. You can describe allergies, medical dietary needs, religious restrictions, or personal preferences.

How many people live in your household?

Do you have reliable transportation to get groceries?

Yes
No

What is your current ZIP code?

Food assistance and nutrition services professional resources and assistance programs