NRCS Family Outreach Form
Please complete this form if you are experiencing a hardship and and you think you may benefit from the social work services from the district social worker at NRCS.
Please remember that there has been an influx of need here in North Ridgeville. There is only one school social worker and she is diligently collaborating, linking, and consulting with families throughout the district on a daily basis. It may take some time for her to reach out. If this is a mental health emergency please call 911 or your local police department for assistance. If you are going to be experiencing homelessness in less than two weeks please email
with a subject line of "Help Now" for quicker communication.
Student(s) First and Last Name
I have student(s) that attend:
Who is filling out this form?
Contact Information (phone number and email)
Are you experiencing any of the following?
Illness due to the Coronavirus
Lack of Internet/Wifi or Connection Problems
Behavioral Concerns for your student(s)
Mental Health/Social/Emotional Concern for self/family member (student)
Are you interested in?
Assistance with deliveries for school bagged breakfast/lunch
Help applying for emergency unemployment
Help applying for medicaid, food stamps, or cash assistance
Mental Health support coordination
Additional information or assistance requested that is NOT listed on this form you'd like to share with the social worker?
Never submit passwords through Google Forms.
This form was created inside of North Ridgeville City Schools.