If You Need Help! Greater Charlotte Rise COVID-19 Mutual Aid

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We are a group of local residents who have come together during a time where some people are finding it hard to access the help they need.

We would like to support the community that we live in and ensure that nobody is left isolated or without support. We don’t ask for anything in return, we just believe in helping each other in a time of difficulty.

We are your local neighbors and not a professional body. We can only offer help within reason, and in ways, we can also stay safe. If you need medical advice, use the NCDHHS online coronavirus site, ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina, or if you have no internet access, call 866-462-3821from your phone. In a medical emergency, dial 911.

Email *

What is your name? (Please indicate your pronouns as well, if that's something you would like to share.) *

What is your street address? *

What is your zip code? *

What is your phone number? *

How do you prefer to be contacted? *

Text

Phone Call

How can we help? *

Picking up food?

Picking up medication?

A friendly phone call?

Sending mail?

Urgent medical supplies?

Other:

Do you need a donation? *

I am able to pay for the items I need

I am not able to pay for the items

I didn't request shopping assistance.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms