[COVID-19] Household Information Form
In these days of physical distancing, we want to be sure we are still able to remain deeply connected. We want to be there for each other, and care for each other.

To enable us to do this we are asking every household in our community to fill out this form.

Please do this as soon as you can, to enable us to nimbly respond to the constantly unfolding situation.

Your sharing of this essential information will allow us to respond to this moment with robust community care. The information will be kept confidential and used only in our COVID-19 response, viewable only to select staff and to key background-checked volunteer leaders.

If you have questions, please contact us at amy@foothillsuu.org and we will connect with you at our earliest convenience.
Email address *
Who is filling out this form?
First Name *
Your answer
Last Name *
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