Request edit access
tkk surgery care team
If you're thinking, "Hey, I'm ready to help!"...first of all - THANK YOU, eternally. Thank you for your offers of help - from rides, healthy meals, care packages and visits, to reiki, mini concerts, poetry readings, FUNraisers and kitty care - we'll gratefully accept it all! Please fill out your info below and it will go directly to my great friend, bread baker and ED of API Equality-LA, Audrey Kuo, to be added to a spreadsheet that you will be able to access and give specific ways that you want to help. Audrey will also follow up with an email including up-to-date information on actual needs in the short, mid and longer term, as we learn more over the next several weeks about my medical path.
First Name *
Your answer
Last Name
Your answer
gender pronouns (e.g. he, she, they) *
If you are signing up as a couple/family, you can respond with multiple responses, (e.g. Audrey: they, Peanut: he, traci: she)
Your answer
Email address *
Your answer
Phone number
Your answer
Home things -- I can help with:
Health support - I can help with:
FUNraiser support
Any other notes on what you can offer?
Your answer
Notes/affirmations (to be shared with traci)
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service