EMERGENCY RESIDENTS RELOCATION - NORCAL & SOCAL WILDFIRES
Please provide your available bed space and facility information below. 6Beds will forward your information to DSS.
Licensee Name *
Your answer
Contact Name *
Enter your First and Last name.
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Phone (mobile preferred) *
Your answer
Facility Region
Facility City *
Please enter the city of your facility/facilities.
Your answer
Facility Type(s) *
Required
Total Available Beds *
Enter how many beds available for each facility type (eg ARF and/or RCFE)
Your answer
Comments
(Optional) Enter additional facility/facilities information here.
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