Support At Home Form
Get Started with Fully Funded Support At Home Nutrition Support
Complete this quick form, and our team will confirm your eligibility and handle everything with your Support At Home Provider.
- No out-of-pocket cost — covered by your Support At Home Package
- Backed by accredited dietitians
- We handle the paperwork with your provider
By submitting this form, you agree to be contacted by Eat Well Health about your eligibility for funded nutrition support. Your information is kept private and will only be shared with your Support At Home Provider if you choose to proceed. Privacy Policy