Home Delivered Nutrition
Nutrition Education Materials
These materials are based on questions from the Nutrition Screening Checklist and may be branded with your organization's name, address and logo.
- I take three or more different prescribed or over-the-counter drugs a day. (.doc)
- Without wanting to, I have lost or gained 10 pounds in the last 6 months. (.doc)
- I eat fewer than two meals per day. (.doc)
- I have three or more drinks of beer, liquor or wine almost every day. (.doc)
- I have tooth or mouth problems that make it hard for me to eat. (.doc)
- I don't always have enough money to buy the food I need. (.doc)
- I eat alone most of the time. (.doc)
Training Materials
- UAI - User's Manual (.pdf)
- Virginia Food Regulations 2007 (.pdf)
Frequently Asked Questions (FAQ)
Service Standards
- Service Standards (.pdf)
- Template for Plan for Infrequent Delivery of Home Delivered Meals (.doc)
- Menu Planning Guidelines (.doc) 09/28/2007
Reporting Forms
- Aging Monthly Report (AMR) (.xls)
- send to: reports@vda.virginia.gov - Nutritional Screening Checklist (.pdf)
- Nutritional Screening Checklist - same as above without color (.pdf)
- Uniform Assessment Instrument (.pdf)
- UAI - Consent to Exchange - Forms and Instructions (.pdf)
- VDA Nutrition Monitoring - HDM (.doc)
(03/31/2006) - Federal Poverty / VDA Sliding Fee Scale - Majority VA (.pdf)
- Federal Poverty / VDA Sliding Fee Scale - Northern VA (.pdf)
- Virginia Caregiver - Service Form (.pdf)
Contact
Elaine Smith
Program Coordinator
Phone: (804) 662-9319
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