Meal Order Form

call now: (757) 644-6819 or (757) 644-6821 |

Meal Order Form



Full Name:		Date:


HMR® Shakes Soup and Cereal

800 CHOC	800 VAN	70+ (Lactose Free) CHOC	70+ (Lactose Free) VAN	500 CHOC	500 VAN	500 CHICKEN SOUP	120 CHOC	120 VAN	Multigrain Hot Cereal


HMR® Entrees

Chicken Creole	Chicken Pasta Parmesan	BBQ Chicken w/Rice & Beans	Lasagna w/ Meat Sauce	Mexican Bean & Beef Enchiladas	Savory Chicken	Turkey Chili

Vegetable Stew w/ Beef	Cheese & Basil Ravioli	Five Bean Casserole	Mushroom Risotto	Beef Pot Roast	Beef Stroganoff	Pasta Fagioli


Benefit® Bars		Additional Items

Blueberry	Chocolate Chocolate	Honey Graham	Peanut Butter

PB2	CHOC PB2	Blender Bottle	Benefiber

Always Consult Your Physician before beginning any Diet or Exercise Program.

Tidewater Bariatrics, PLLC 1405 Kempsville Rd., Chesapeake, VA 23320 Ph: (757) 644-6819 or (757) 644-6821

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