Outreach Assistance Request
  Our outreach services are designed for unhoused individuals within Buncombe county who cannot regularly access AHOPE or other service agencies due to barriers such as transportation, bus line access, mental health, trust, etc.  We assist with basic needs such as food, water, hygiene supplies, cold weather supplies. We are an access point for completing intake for the local coordinated entry system. We also provide referrals and connection to community resources for other urgent needs along with system navigation. 

Important: Submitting this form does not guarantee immediate assistance, but it helps our team prioritize urgent needs and connect clients to the right resources.  
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Date *
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County  *
Full Name  *
Street Name/ Nickname 
Date of Birth 
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Referring Entity  *
Name of Person submitting referral  *
Phone number and/or Email 
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