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Eligibility Survey

The High Desert Food & Farm Alliance's VeggieRx program provides FREE fresh food and nutrition education for 8 sessions for people who have less access to fresh vegetables and fruit. 

Please complete the following 5-minute questionnaire to help us determine if you can participate in the program. Completing this form and participation in the program are voluntary. Any information you provide to HDFFA will remain confidential.

If you are eligible, you will be contacted by the phone number you provide below. We may ask your referring medical professional about your current health conditions. If you agree to be contacted expect to hear from us within 2 weeks after you complete this form. If you have any questions or concerns please contact Hannah Brzozowski at 541-610-6046 or
1. Are you 18 years of age or older? *This question is required.