COVID-19/ Coronavirus South King County & Eastside Mutual Aid "Request Support" Form
Neighbors Helping Neighbors. Mutual aid support for survivors, sick & disabled, immunocompromised, undocumented, black, queer & transgender, indigenous, and or people of color. If you would like to have groceries dropped off, please complete this form.

Right now, the soonest we can respond to your request is 1 week, with the average time waiting for response is 2 weeks. We appreciate your patience and understanding. Please DO NOT submit this form multiple times while waiting for us to respond to you. If you are worried your request may have been misplaced, send us an email: covid19mutualaideastside@gmail.com
Once your most recently delivery of groceries has been completed please fill out this form again to request support.

We are a collective of people from neighborhoods and communities within the region of South King County & the Eastside building community care and power. We formed at the beginning of the COVID-19 pandemic to provide support to those impacted by the pandemic.

We share resources, support survivors in safety planning, and work to provide basic needs to folks, which include groceries, help paying bills, and forming fundraisers for those who need it.

**We center our work in abolition, that those most harmed by systems of power must be centered in creating new ways of caring for each other, and that our liberation AND our wellbeing are interconnected.**

Formulario para Solicitar Entrega de Suministros: https://forms.gle/NMWtq2Hky3aWQPkZ7

"Mutual aid is “cooperation for the sake of the common good.” It’s getting people to come together to meet each other’s needs, recognizing that as humans, our survival is dependent on one another." - Mariame Kaba

Volunteers: We need your support!
- Please check out the daily log & sign up for shopping and/or organize to cover a shopping trip to help us get through the backlog of requests.
- If you have not yet, consider supporting us during this high need time by donating, shopping and delivering! You do not need money to pay for the groceries yourself if you would wish not to, we will reimburse you. Sign-up to offer support here: https://tinyurl.com/mutualaidvolunteer

For any questions contact covid19mutualaideastside@gmail.com.
**Request Support Form: tinyurl.com/eastsidemutualaid
**Offer Support/ Volunteer Form: https://tinyurl.com/mutualaidvolunteer
**GoFundMe page: https://www.gofundme.com/f/covid19-eastside-survival-fund
**FB group: www.facebook.com/groups/555635161739149/
Linktree: https://linktr.ee/skc.e.mutual.aid
Name *
Contact Number *
Email Address *
What would be the quickest method of reaching you? *
This form is for South King County & Eastside. If you're in Seattle, please complete this form: https://docs.google.com/forms/d/1rOkXW6ElVT0MH9oSI-TuW8L5szCt-ULbZhWebARRZNI/viewform ). Where in South King County or Eastside are you located? *
Required
What is your address? (Address, City, State, ZIP Code) *
If you live outside of our service area, can we send your request details to another local mutual aid organization who we trust? *
If you say yes, it will be will be faster and simpler to get you your delivery! If you say no and you live outside of our range, we will let you know that we can't help you and tell you where to go to find help for your location, which may take a while, and then you will have to fill out another group's form and begin the whole process again from scratch. (We will never share your information with advertisers, political candidates or parties, corporations, or the government.)
What kind of food would you prefer? *
Required
We are on a volunteer basis and actively fundraising. At this moment we are set up to prioritize delivering ONLY ESSENTIAL/URGENT/ IMMEDIATE needs of our community members. What are the essential/ urgent items you need? *
Items can be general like "milk," or specific like "a 24-pack of the purple Always brand overnight menstrual pads with wings." We will do our best to match your requests, but if we can't find something specific we may get you a similar substitute. We trust you to know your needs and we are committed to delivery without judgement.
Do you have any restrictions, allergies or intolerances? If there are no allergies/ restrictions, enter none. *
How many individuals are in your household? *
How urgent is your need? Right now, due to the number of requests we receive, the soonest we can contact you back is within a week. *
Would you like financial support with your delivery? *
*We can fund supplies up to a certain amount per request (While funding lasts) for folks who are quarantined without pay, sick, disabled, elderly, undocumented, queer, Black, Indigenous, and/or people of color.
Can you tell us about your social location, privileges you do or don’t have, whether you are Black, Indigenous, Person of Color (BIPOC), identify as a survivor of domestic or sexual violence, etc. *
Is it okay to share your contact number, address, and grocery list with the volunteer who is doing the delivery? *
Would you like us to check in via text or call every few weeks to support you in your health and wellbeing? *
Are there things you would like us to know? (any support or resources you would like to offer, questions, comments, concerns).
Are you interested in joining your neighborhood mutual aid pod or need assistance in setting up your own mutual aid pod to support yourself and your neighbors with current/ future needs? If so, please go this link to join our Neighborhood Mutual Aid Pods Group: tinyurl.com/KCMutualAidPod
Clear selection
Is there anything else you would like us to know about resources you can offer? *
In the near future, we are considering expanding the types of mutual aid we offer. These might include emotional support, household chore assistance, childcare, dog walking, etc. Please note access details when possible, like: are you able to be scent-free (http://thinkbeforeyoustink.com/howtogofragrancefree.html)? Can you speak several languages, or sign languages? Do you have a wheelchair accessible van?
We know that violence and abuse thrives in isolation, so do keep reaching out to your friends and family and creating online spaces to connect. If you or your loved ones need more resources and support, reach out to any of these organizations: API Chaya (1-877-922-4292), The Northwest Network of Bi, Trans, Lesbian, and Gay Survivors of Abuse, The Arc of King County, MCRC Seattle, CAIR Washington, National Domestic Violence Hotline King County Sexual Assault Resource Center, MAPS AMEN, National Human Trafficking Hotline: 1-888-373-7888.
We're so glad you've reached out to us for support. We will try our best to get back to you within 7 days as to whether we can meet your request. Thank you for your patience and grace. Once you submit this form, please DO NOT submit again until you hear back from us. If you are worried that your request has been lost contact us via email: covid19mutualaideastside@gmail.com
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