Lewis County Senior Personal Intake Form

Below is the link to Lewis County Seniors Personal Information Form. This is required for all senior nutrition meal participants at their first time of visit. Feel free to print out a copy and fill it out prior to your visit.

Please Note: This information is confidential, like a census, we submit this information to State and Federal programs for help and financial support. These forms stay at the local center that you submit them to. Please bring us your form to be sure everyone is counted.

Click Here:

LEWIS COUNTY SENIORS PERSONAL INTAKE FORM 2022

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