COVID-19 - Sacred Medicine Request

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This form is for individuals or families needing sacred medicines for ceremonial purposes during COVID-19. Medicines will be distributed through contact free delivery to those in need.

Please fill out the following information so we can ensure we are providing support in the best possible way.

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Name: *

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Contact (phone or email): *

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How do you identify? *

First Nations

Inuit

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Non-Indigenous

Address: *

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