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, indigenous, and or people of color. If you would like to have groceries dropped off, please complete this form.
Formulario para Solicitar Entrega de Suministros:
"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:
For any questions contact
**Request Support Form:
**Offer Support/ Volunteer Form:
What would be the quickest method of reaching you?
Phone Number - Call
Phone Number - Text
This form is for South King County & Eastside. If you're in Seattle, please complete this form:
). Where in South King County or Eastside are you located?
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?
Ingredients to cook with
Reheat and serve/frozen
Low Prep (like sandwiches, pasta)
Zero - Prep
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? Please allow us 48 hours to respond to your request.
In the next 72 hours
Over the next few days
Useful if available
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.
Pay with your own money and donate to support your community members:
Pay with your own money (coordinate with delivery person)
Request support with your delivery items
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?
Yes, by text
Yes, by phone
No, thank you
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:
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 (
)? 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, 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 48 hours as to whether we can meet your request. Thank you for your patience and grace.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service