Impact Form

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

Impact Form

Please complete this form AFTER or WHILE receiving assistance from The Action Center.

At the Action Center, we believe in the incredible resilience and potential of our community members. Your journey and experiences matter to us, and we want to give you the opportunity to share your story in a way that highlights your strengths and the positive impact of the assistance you've received.

Your unique story can inspire others and help us improve our services. We are committed to treating your story with the utmost respect and tact, ensuring that your privacy is protected. Your responses will be kept confidential, and we will only share your story with your explicit permission.

Clear form

Never submit passwords through Google Forms.

This form was created inside of The Action Center. Report Abuse

Forms