Stay Healthy & Stay Connected!
Sign in to Google to save your progress. Learn more
Community Living Campaign is committed to preventing isolation as we all weather the Coronavirus outbreak. While we are limiting in-person gatherings as directed by the San Francisco Department of Public Health, we will do all that we can to find safe ways to keep all of us engaged, active, and connected. Please join in!
Name *
Mailing Address (Street, City, Zip Code) *
Email Address
Preferred Phone Number *
Preferred Language
When we can’t meet in person, how are you most comfortable connecting from home? (Please check all that apply)
How would you like to receive print materials?
Clear selection
WAYS TO STAY CONNECTED
We are all learning together, and we want your opinion on what will be most useful to you while we’re unable to meet or hold classes at our regular Community Connector locations.
Very Interested
Somewhat Interested
Maybe
Not for Me
Individual calls from the Connectors to check in
Having a phone buddy from my Community Connector group to talk with regularly
Scheduled group social calls (everyone calls into one number, with a Connector to help facilitate)
Scheduled workshops accessible by phone or online video, with materials sent out by email or US Mail
Short workout videos on CLC’s website, YouTube, and/or Facebook page
Outdoor Activities where we can still practice the CDC’s recommended “social distancing”
Volunteering to help bring necessities to a neighbor
Clear selection
What else would be helpful for you?
Are there ways you'd be willing to help as we try to keep our neighbors connected and safe?
CONNECTING ONLINE
Are you able to go online from your home? (If yes, please check all that apply)
Is there anything else you'd like to share -- including questions and concerns -- as we work to keep everyone connected during this time?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Community Living Campaign. Report Abuse