Greater Fort Lauderdale Diaper Bank Intake Form

Intake must be completed every six months.

The Greater Fort Lauderdale Diaper Pantry will take place on the 1st Thursday of each month from 6-7pm.

To get diapers the intake form must be completed and you must submit the proper paperwork including submitting a copy of your Medicaid Card/Healthy Kids Card or proof of income.

Monthly registration required after initial intake. You must put the Child's size diapers in your monthly registration.

Diapers can no longer be picked up by friends or relatives other than the primary caregiver(s).

We will now be checking ID. Each month the Primary caregiver will need to present their state issued ID. If you do not have an ID you will not be able to get diapers.

After you complete the intake you will get a verification card to present at each month's diaper pantry. If you do not have your verification card you cannot get diapers.

We cannot guarantee a certain brand or size of diapers. We can only give out what we have.

Diapers are for individual use only. You may not sell diapers that are donated by the Greater Fort Lauderdale Diaper Bank. If you are caught selling or misusing diapers you will no longer qualify.

The name and photo associated with your Google account will be recorded when you upload files and submit this form

Greater Fort Lauderdale Diaper Bank Intake Form

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