Town of Buxton: Community Outreach Form

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The Town of Buxton is working to extend outreach efforts to community members who are in need of assistance during the COVID-19 outbreak. Please fully complete the below questionnaire if you, or someone you know, is in need of any of the following services.

Once you have completed this form, someone will be in contact with you within 24 hours.

Please note- this form is not for emergency services or transportation. If you have a medical emergency, please dial 911.

If you have questions, please call 207-841-7320.

I am a resident of Buxton.

Yes

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Full name and phone number of person completing this form. *

Full name and phone number of person in need of services. (if different than above) *

How can we help you? *

I would like a social phone call 1-2 times per week.

I would like to coordinate a medication pick-up for someone in my household.

I would like to coordinate a Hannaford To Go pick up for my household.

I would like to coordinate a Food Pantry Pick-Up for my household.

I would like to coordinate mail pick-up/drop off for my household.

Other:

Required

Has the person in need of services been diagnosed with, or been in contact with someone, who has been diagnosed with COVID-19?

Is there any other information that you would like to share?

Submit

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