Request for Aid During COVID-19: Fairfax County
Please fill out this form if you'd like assistance during the COVID-19 outbreak as we try to limit the spread of the virus. We'd like to help the elderly, those with disabilities, nursing moms, low-income families, or those who speak English as a 2nd language and may have trouble accessing aid.
Name *
Your answer
Number *
Your answer
Your Email *
Your answer
Do you need assistance with English? *
Your Zip Code *
Your answer
How would you like to be contacted by one of our volunteers? *
Required
What kind of aid do you need? *
Required
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