SF Community Support - Request Form  πŸ™ŒπŸΏπŸ™πŸ½πŸ’ͺ🏻
Welcome. Consider that this is a great moment to take a full breath! You've found yourself in a nice part of the internet.

If you are in need, you can use this form to request grocery or prescription deliveries and other forms of support. We are an all-volunteer grassroots group of your neighbors -- we aim to respond within 24 hours.

Things we CAN help with: Grocery delivery, prescription pickup, and other errands; dog walking and pet care; 1:1 Phone calls and support check-ins, and tech support (e.g. help with delivery apps, video conferencing)

Things we CANNOT help with: large-scale financial support (e.g. rent payment, child support)

***You can fill this form out on behalf of someone!*** Please indicate and share your name at the end.

If you're looking to offer support, please go here: https://forms.gle/mcCDXLtJr8Y4ZeWq7

Facebook: https://www.facebook.com/groups/communitysupportsf/
Our website: sfcommunitysupport.org
Questions: reach out to hello@sfcommunitysupport.org
---
***DISCLAIMERS: By completing the request form to be matched to a volunteer, you agree that you accept all risk and responsibility and further hold any facilitator associated with SF Community Support harmless. All volunteers are guided to follow the best hygiene and health methods from public health officials, including no-contact drop offs.

Personal Data: We are utilizing the technology that is most effective for us. While we are making great efforts, we cannot guarantee the security of your personal information -- as such please be judicious about what you share. Any information passed through is at your own risk.
Sign in to Google to save your progress. Learn more
Name *
Email address *
Phone Number *
Neighborhood *
Any language restrictions?
Clear selection
What type of support are you seeking? *
Please provide additional information in the next question. Note: We do NOT provide direct financial assistance.
Required
Share more about your needs related to this support *
If grocery, please be as specific as you can (eg. ingredients to cook with, reheat/frozen food, low-prep like sandwiches, zero-prep ready-to-serve), along with any dietary restrictions, allergies, intolerances. If you need someone to pick up prescriptions, please provide contact info or include all relevant info (legal name, birth, names of medication)
Your Address
Please leave blank if not applicable.
If applicable, how can you reimburse the volunteer for costs related to your request (i.e. groceries or meds)?
Which payment methods work for you?
Are you in need of (temporary) free/subsidized food resources?
We have very limited funds, donated by other community members, to reduce food costs and work together with supermarkets that can provide low-cost/free food care packages (up to 2 times). We do not provide financial assistance for any other reason than food costs.
What day and time do you need things by?
We can't guarantee timing, but will do our best.
How regularly would you like this support provided?
Please specify if applicable (eg. Groceries every 2 weeks, meal pickup every Saturday, etc) NOTE: While we cannot promise a regular routine, we will try our best to match you up!
Anything else you'd like your neighbors who are helping out to know about you?
We will try to let you know if we can meet your request within 24 hours.
Inspired from community efforts globally, we aim to cultivate an environment of safety, creativity, collaboration, and love as we face the COVID crisis.
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
Google Forms