NRS Covid-19 Help Request

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Please complete this form if you are affected by the restrictions from Covid-19 and would like some support from other members of our community who are able to help. Perhaps you need an errand running, some food or medication or a friendly voice on the phone.

If you need help please leave your details below.

These details will be stored on a secure Google account with limited and passworded access by a small trusted team from the NRS community. We will not share your details with anyone other than linking you up with a paid up member or friend of our community. Following the crisis, these documents will be deleted.

If you are not comfortable with the above, please do not leave your details

Using the same link you can update your response at any time to indicate different needs or length of help required.

Keep well and keep safe

Your NRS Council

Name *

Phone number *

Area you live (please do not leave your full address. This is to match you to someone close by who you can give your details to directly)

What type of help do you need?

Errands / shopping

Cook and deliver meals

Chat on the phone / digitally

Dog walking

Collecting prescriptions / medication

Other:

Expected end to self isolation or social distancing (please come back and edit this at a later date if your information changes) *

YYYY

Submit

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