MGFA Food Support Program, co-created with UCB

Thank you for your interest in MGFA’s Food Support Program. This program delivers dependable, nutritious meals that reduce barriers to proper nutrition, helping myasthenia gravis patients improve their overall health and wellbeing. This program is open to households living in the U.S. with a confirmed myasthenia gravis diagnosis.

Applications must be submitted through this page once enrollment opens.

Participants will be selected based on a set of formal eligibility criteria. Applications are reviewed on a rolling basis, and applicants will receive feedback no later than Octover 20, 2026. Patients who qualify will be contacted directly by an MGFA staff member.

In 2026, MGFA plans to support the community through two distinct program cohorts; one in the summer and one in the winter. Enrollment for each cohort is limited, and applications will close once capacity for that cohort is reached.

For those selected in the winter cohort, meal delivery will begin November, 2026.

SECTION 1 — Personal & Contact Information. If you are filling this intake out on behalf of a loved one with myasthenia gravis, please utilize their information to answer the questions

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1. Full Name: (Required.)

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2. Date of Birth: (Required.)

Date

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3. Address: (Required.)

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4. Phone (Required.)

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5. Email: (E-communication opt in. By entering your email address, you are agreeing to receive MGFA communications via email. This includes Privacy updates, MGFA related information and news.)

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6. Preferred Contact Method: (Required.)

Phone

Text

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7. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Prefer not to answer

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8. What is your current employment status? (select one)

Employed, full time

Employed, part-time

Self-employed

Unemployed

Unable to work due to myasthenia gravis

Retired

Prefer not to answer

Other (please specify)

SECTION 2 — Myasthenia Gravis (MG) Diagnosis

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9. I attest that I have been diagnosed with Myasthenia Gravis (MG) by a healthcare provider. (Required.)

Yes — I have an MG diagnosis

I am completing the application for someone in my household with an MG diagnosis

Unsure

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10. Healthcare Provider’s Name (optional but preferred):

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11. How was your diagnosis confirmed? (Required.)

Neurologist

Primary Care Provider

Other (specify)

SECTION 3 — Physical Need, Financial Need, and Access to Food.Please respond to the following questions as they relate to your household’s financial circumstances during the past 12 months.

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12. Physical Need: Do you currently experience any difficulty with chewing or swallowing food?

I do not have difficulty chewing or swallowing food.

Mild difficulty (sometimes I have issues)

Moderate difficulty (Most of my meals require soft foods or extra time to eat)

Significant difficulty (requires modified food to prevent choking i.e. pureed food)

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13. Financial Need (select all that apply):

My household income is limited or variable

I have significant medical expenses

I currently receive assistance (e.g., SNAP, Medicaid, SSI/SSDI)

I am experiencing financial hardship for other reasons

Other (please specify)

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14. What is your total annual household income before taxes?

less than $25,000

$25,000-$49,999

$50,000-$74,999

$75,000-$99,999

>$100,000

I prefer not to answer.

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15. Please respond to the following statement: “I worried whether my food would run out before I had money to buy more.”

Often true

Sometimes true

Never true

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16. Please respond to the following statement: “The food I bought just didn’t last and I didn’t have money to get more.”

Often true

Sometimes true

Never true

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17. Do you currently receive any of the following forms of assistance? (Select all that apply)

Snap benefits, WIC, SSI, and/or SSDI

I prefer not to answer

Other (please specify)

None of the above

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18. How often does myasthenia gravis limit your ability to shop, prepare, cook, or eat meals?

Always or nearly always (daily basis)

Often (3-5 times a week)

Sometimes (couple times a week)

Rarely (couple times a month

Never

Other (please specify)

SECTION 4 — Household Information

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19. Total number of people in your household: (Required.)

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20. Please specify total number of adults and children in household:

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21. Number of people in household with myasthenia gravis: (Required.)

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22. Do you require regular help cooking, shopping, and preparing meals at home?

Yes

Sometimes

Other (please specify)

SECTION 5 — Meal Program Fit & Safety Requirements

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23. Do you have regular access to a refrigerator and/or freezer to properly store meals? (Required.)

Yes

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24. Do you have regular access to at least one of the following appliances needed to prepare frozen meals: a microwave, oven, or stove? (Required.)

Yes

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25. Do you have access to the internet (such as on a phone, tablet, or computer) to choose your meals online each week? (Required.)

Yes

Dietary Preferences. As with any meal delivery program, options are available to help accommodate dietary restrictions and preferences. Please list any dietary restrictions or preferences that apply to your household.

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26. Yes — please list:

SECTION 6 — Consent & Attestation

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27. Please check the box below (Required.)

I acknowledge that completing this application does not guarantee enrollment in the MGFA Food Support Program and that all information provided is true and accurate to the best of my knowledge.

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28. Applicant Signature (Required.)

Optional Information (for program evaluation only)

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29. Which of the following best describes your primary challenge in accessing or preparing meals?

physical limitations

financial limitations

both physical and financial limitations

prefer not to answer

Other (please specify)

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30. What is your race/ethnicity (Select all that apply)

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or other Pacific Islander

White

Prefer not to Answer

Other (please specify)

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100% of survey complete.

MGFA Food Support Program, co-created with UCB

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* 1. Full Name: (Required.)

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* 2. Date of Birth: (Required.)

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* 3. Address: (Required.)

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* 4. Phone (Required.)

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* 5. Email: (E-communication opt in. By entering your email address, you are agreeing to receive MGFA communications via email. This includes Privacy updates, MGFA related information and news.)

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* 6. Preferred Contact Method: (Required.)

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* 7. What is your age?

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* 8. What is your current employment status? (select one)

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* 9. I attest that I have been diagnosed with Myasthenia Gravis (MG) by a healthcare provider. (Required.)

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* 10. Healthcare Provider’s Name (optional but preferred):

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* 11. How was your diagnosis confirmed? (Required.)

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* 12. Physical Need: Do you currently experience any difficulty with chewing or swallowing food?

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* 13. Financial Need (select all that apply):

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* 14. What is your total annual household income before taxes?

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* 15. Please respond to the following statement: “I worried whether my food would run out before I had money to buy more.”

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* 16. Please respond to the following statement: “The food I bought just didn’t last and I didn’t have money to get more.”

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* 17. Do you currently receive any of the following forms of assistance? (Select all that apply)

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* 18. How often does myasthenia gravis limit your ability to shop, prepare, cook, or eat meals?

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* 19. Total number of people in your household: (Required.)

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* 20. Please specify total number of adults and children in household:

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* 21. Number of people in household with myasthenia gravis: (Required.)

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* 22. Do you require regular help cooking, shopping, and preparing meals at home?

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* 23. Do you have regular access to a refrigerator and/or freezer to properly store meals? (Required.)

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* 24. Do you have regular access to at least one of the following appliances needed to prepare frozen meals: a microwave, oven, or stove? (Required.)

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* 25. Do you have access to the internet (such as on a phone, tablet, or computer) to choose your meals online each week? (Required.)

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* 26. Yes — please list:

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* 27. Please check the box below (Required.)

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* 28. Applicant Signature (Required.)

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* 29. Which of the following best describes your primary challenge in accessing or preparing meals?

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* 30. What is your race/ethnicity (Select all that apply)

1. Full Name: (Required.)

2. Date of Birth: (Required.)

3. Address: (Required.)

4. Phone (Required.)

5. Email: (E-communication opt in. By entering your email address, you are agreeing to receive MGFA communications via email. This includes Privacy updates, MGFA related information and news.)

6. Preferred Contact Method: (Required.)

7. What is your age?

8. What is your current employment status? (select one)

9. I attest that I have been diagnosed with Myasthenia Gravis (MG) by a healthcare provider. (Required.)

10. Healthcare Provider’s Name (optional but preferred):

11. How was your diagnosis confirmed? (Required.)

12. Physical Need: Do you currently experience any difficulty with chewing or swallowing food?

13. Financial Need (select all that apply):

14. What is your total annual household income before taxes?

15. Please respond to the following statement: “I worried whether my food would run out before I had money to buy more.”

16. Please respond to the following statement: “The food I bought just didn’t last and I didn’t have money to get more.”

17. Do you currently receive any of the following forms of assistance? (Select all that apply)

18. How often does myasthenia gravis limit your ability to shop, prepare, cook, or eat meals?

19. Total number of people in your household: (Required.)

20. Please specify total number of adults and children in household:

21. Number of people in household with myasthenia gravis: (Required.)

22. Do you require regular help cooking, shopping, and preparing meals at home?

23. Do you have regular access to a refrigerator and/or freezer to properly store meals? (Required.)

24. Do you have regular access to at least one of the following appliances needed to prepare frozen meals: a microwave, oven, or stove? (Required.)

25. Do you have access to the internet (such as on a phone, tablet, or computer) to choose your meals online each week? (Required.)

26. Yes — please list:

27. Please check the box below (Required.)

28. Applicant Signature (Required.)

29. Which of the following best describes your primary challenge in accessing or preparing meals?

30. What is your race/ethnicity (Select all that apply)