Encampment Concerns & Support Request

This form is for community members, businesses, and concerned individuals to notify us about encampments or individual campsites of individuals experiencing homelessness.

Use this form to

 Share the location of an encampment or individual so outreach staff can check on wellbeing and connect people to services.

Express concerns for the safety or wellbeing of people camping.

Request support in addressing encampments that have become problematic near businesses or properties to avoid law enforcement involvement. 

Request Purple trash bags and or connection to trash/waste removal services. 

Please Note: Submitting this form does not guarantee immediate response or removal. Our goal is to provide outreach, connect people with resources, and support both individuals experiencing homelessness and the surrounding community.

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Date *
MM
/
DD
/
YYYY
County  *
Name
Affiliation 
Clear selection
Contact Information
Phone , email , etc.
Location of Encampment
Please provide as much detail for directions to encampment site.  Nearest Address or Reference Point 
Type of concern
Description/ Additional details 
Number of people, animals, tents, vehicles, observed issues, etc. 
Permission to contact you for follow up  *
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This form was created inside of Homeward Bound of Western North Carolina.

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