Mobile Food Pantry

You have been referred to Capital Compassion’s Mobile People’s Choice Food Pantry through 211. This program serves older adults (65+) with permanent housing in the 95670 community who are experiencing food insecurity and have health-related transportation challenges that make it difficult to shop for groceries or visit a food pantry.

Approved participants receive personalized grocery and meal deliveries directly to their home, ensuring consistent access to nutritious food with dignity and care.

Your name *

Email address *

Address *

ZIP CODE 95670 ONLY - Do not proceed if outside of 95670

Phone number *

Birthdate *

Gender *

Marital status *

Please select the ethnicity you most closely identify with: *

What is your native language/ languages *

Are you currently receiving EBT/Cal Fresh benefits? *

Are you currently receiving Social Security benefits? *

Are you a veteran? *

Managed Health Care Provider *

Medical Notes

Dietary Restrictions *

Household members

A copy of your responses will be sent to your email address.