Phone Me I would like further information or would like to signup on the phone.
Name 
Phone
 
Current Customers I am a returning customer Healthy Diet Delivery.
Name 
Phone
 

Sign Up Now
Delivery Information
First Name
Last Name
Address
Address (con't)
Closest Major Intersection
City
State
Zip Code
Day Phone ext.
Evening Phone
e-mail
Select Your Program
We offer 4 plans for your convenience where you can select service for 3 or 5 days per week.

Plan
60-Day Plan $35.99 per day
45-Day Plan $37.99 per day
30-Day Plan $39.99 per day
15-Day Plan $44.99 per day
* Plus Applicable Taxes and Delivery.
I would like to sign up for
Start date Calendar
Days I would like service
Monday  Tuesday  Wednesday  Thursday  Friday  Saturday  Sunday 
Payment
Payment Options
Credit Card Type  
Name On Card  
Credit Card Number  
Expiration Date / (mm/yyyy)  
  Security Code (last 3 digits after card number on back of card)  
Policies
I have read and understand the delivery policy for damage and theft.
Damage and Theft Policy Healthy Diet Delivery will assume the responsibility for the theft or damage of 1 days worth of food under the following conditions.
1) the drop off location is mutually agreed upon.
2) for deliveries to outside locations, a plastic tote/bin (with a lid)or the equivalent is provided by the customer for Healthy Diet Delivery cooler bag to be placed inside.
I do not have any life threatening allergies.
I understand that I should consult my physician before starting any meal program.
DisclaimerThis program is not intended to replace medical advice. If you are under the care of a physician and/or take medications for diabetes, heart disease or hypertension, consult with your health care provider prior to initiation of this or any dietary program. Implementation of this dietary program may require altercation in your medication needs and must be done by or under the direction of your physician.