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Need Gluten-Free Food Assistance? We Are Here for You.

If you or your child require a gluten-free diet and you are struggling financially, please fill out our confidential request form.

Our support is:

Free
Confidential
Based on availability
Provided with love and respect

You are not alone. You belong in the Ring.

1. Contact Information

Full Name *

Phone Number *

Email Address (optional)

City & Zip Code *

Preferred Contact Method *

2. Household Information

Number of adults in the household *

Number of children in the household *

Ages of children (if any)

3. Gluten-Free Needs

Who in your family requires a gluten-free diet? * (Check all that apply)

Myself Child Spouse Parent Other

Do you or your family member(s) have any of the following? * (Check all that apply)

Celiac Disease Medically diagnosed gluten intolerance Non-celiac gluten sensitivity Wheat allergy

Other dietary restrictions

4. Financial Need

Are you experiencing financial difficulty purchasing gluten-free food? *

Please briefly describe your situation

5. Dietary Notes

Do you have any additional dietary requirements? (Check all that apply)

Dairy-free Nut-free Soy-free Egg-free Vegan

Other allergies

6. Assistance Type Requested

What kind of help do you need right now? *

7. Pickup or Delivery

Preferred method *

Please explain your delivery needs

8. Consent & Agreement

I understand that Gluten-Free Rings Food Bank provides donated gluten-free foods as available. Items are given "as-is," and I am responsible for checking ingredients and suitability for my family. I certify that the information provided is true and accurate. *

Signature (type your name) *

Gluten-Free Rings Food Bank

A nonprofit organization providing safe, gluten-free food assistance to families with celiac disease and gluten intolerance in the DFW community.

Because everyone deserves access to safe food.

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Dallas-Fort Worth Area

Founder: Niloo Bidhendi

✉️ [email protected]

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