FMGS Schedule Delivery Form
All fields marked by * are required.
Email: *
First and last name: *
Street address only (include apt#): *
Is a gate code require to access address?: *
If yes, enter code below or name of person to contact:
City: *
Delivery address phone or cell number: *
Can number above accept a text?: *
  • No
  • Yes
Delivery day: (a calendar will open) (no same day deliveries): *
Delivery time (no, exceptions): *
Alcohol I.D. requirement: (no I.D. no alcohol, no refund) *
  • I agree
  • Not ordering alcohol
Sometimes we must make substitutions: *
  • I understand
Do you have any food allergies?: (if no, write no. If yes, what are they) *
Is person receiving the groceries sick with a cold or flu?: *
  • No
  • Yes (we'll knock and leave groceries)
You (name on credit card) will not chargeback a credit card payment made to Fort Myers Grocery Service (FMGS) for any reason. *
  • I agree
Leave instructions or a message: