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Ottawa-Gatineau COVID-19 Relief Form
Given the recent information coming in daily for COVID-19, United Muslim Organizations of Ottawa Gatineau (UMO-OG) is committed to helping anyone in need of assistance.

Fill out the form below if you need any support in this difficult time. Please include all of your personal information as well as indicate the supplies you may need. Grocery pick-up withe-transfers are provided as well. These relief and support services are available to individuals from ALL communities, cultures, and faiths.

If you are having difficulty filling out the form, please call us at: 613-686-3922

CONFIDENTIALITY NOTICE:

These relief and support services are being coordinated by UMO-OG with the support of professional social workers, counsellors, and administrative staff of Muslim Family Services of Ottawa (MFSO - www.mfso.ca). Confidentiality is of the utmost importance to both UMO-OG and MFSO. All information submitted on the following form will be kept confidential, with a few legal limits (for more information on legal limits to confidentiality please refer to the link below), and will only be shared and discussed with the following individuals/representatives:

Soumaya Marhnouj, Masjid Ar-Rahma (AMA)
Momin Janjua, Director, Sidra Treehouse
Mariam Aly, Ottawa Muslim Association (OMA)
William Felepchuk, Executive Director, Muslim Family Services of Ottawa (MFSO)
Malika Nouh, Secretary, United Muslims Organizations of Ottawa-Gatineau (UMO-OG)
Samoon Tasmim MA PhD (Cand.) RPQ, Counsellor/Psychotherapist, Muslim Family Services of Ottawa (MFSO)

Submitted information will be organized and accessed by the above team. Request for food and material support will be forwarded to neighbourhood team of volunteers (Name, Address, and details of items only). Counselling requests will be forwarded to MFSO's confidential intake email address (info@mfso.ca) and will be processed with MFSO's professional and confidential counselling intake process.

Legal limits of confidentiality: https://www.crpo.ca/standard-3-1-confidentiality/
Name *
Your answer
Number of family members: *
Are you at risk? Please select which one (s): *
What area of the city do you live in? *
What kind of help and support do you need? *
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