Groceries to Go Interest Form 2025

Thank you for your interest in the Groceries to Go program. Please complete the form below, and a member of our team will call you to discuss your eligibility to enroll in Groceries to Go and answer any questions you may have. We will not ask about your immigration status or share information submitted through this form.

1. Have you ever participated in Groceries to Go?

2. Is anyone in your household enrolled in Groceries to Go at this time?

3. Do you live within the 5 boroughs of New York City (NYC)? *This question is required.

You must live in New York City to be eligible for the Groceries to Go program.

4. Are you a member of NYC Care at NYC Health + Hospitals? *This question is required.

We will verify your NYC Care membership when we call you to determine your eligibility to enroll in Groceries to Go.

To be eligible for Groceries to Go you must be a member of NYC Care at NYC Health + Hospitals. To learn more about NYC Care or to check your membership status, visit nyccare.nyc or call 646-692-2273.