Curridge-20 Support Request
Please use this form to request help from the Curridge Village support network during the Covid-19 outbreak.

If you are forced to self isolate and need help with urgent supplies, deliveries or companionship please let us know and we will put you in contact with the closest or most appropriate volunteer.

In the case of a medical emergency please do not use this form, and call 111 immediately.

During the current coronavirus pandemic, the parish council and volunteer groups will also use personal data of vulnerable and at risk individuals which has been supplied by them, or by their relatives, to ensure that they are fully supported during the current crisis. The information held will be used for this purpose alone, and will be deleted once the pandemic is at an end. Individuals contacting the parish council for assistance through this scheme will be considered to have given consent for their data  to be used for this purpose.

You may request your details to be removed from our database at any time by emailing cra@curridgevillage.co.uk

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Your Name *
Your Address
We need your address in the village to help connect you with the closest volunteer
House Name or Number *
Street Name *
Contact Phone Number *
Contact email address (optional)
On what date did you start self isolation? *
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/
DD
/
YYYY
Are you in short term isolation due to showing symptoms, or longer term isolation due to being considered at higher risk from the virus? *
Please outline your specific support needs *
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