43rd District Resource/SERVICE REQUEST FORM
Senator Mary Washington has been working in Annapolis with colleagues to pass emergency funding for COVID-19 resources while simultaneously coordinating with people on the ground in the 43rd District to convene a 43rd District Resource Assistance Team with the Baltimore City Delegation. This team is meant to pull together and streamline critical resources to keep you informed, as well as act as a volunteer delivery service for those who may not be able to leave their homes due to being at-risk. Delivery includes only picking up (not ordering) medication, household groceries, food, and any other needs you may have.
The purpose of this form is to provide delivery services for those in the community that do not have the ability to leave their home due to the dangers of COVID-19. Please leave a detailed response in the applicable description box.
After you fill out this Pickup Request Form, we will contact you to go over details and availability. For any further clarification please contact us at 1(800) 291-5457 or
43rddistrictrt@gmail.com
DISCLAIMER: This resource is not for medical advice, but to connect you and loved ones to necessities as well as provide updated information whenever possible. If you need to speak with a medical professional, call your primary care doctor or 2-1-1. If you can't reach 2-1-1, call (410) 685-0525 for the Greater Baltimore Area. You can also visit
health.baltimorecity.gov
for updates from the Health Department.
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Have you used this service before?
I am new
I have used this service before
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For Food Related Needs
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For Medication Related Needs - Pickup ONLY
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Lawn Mowing Services (help). I am a senior over the age 60 or a disabled person who needs my lawn mowed (this service has a 1 week waiting period.)
I am 60 years +
I have a disability
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For Other Pickup Needs
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Contact info
We need this information to proved you with help.
Your name
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Street Address
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What district do you live in?
District 3 (Loch Raven up to Cold Spring, Harford Road Alameda, Argonne)
District 4 (York Road-east or west of 43rd St, Loch Raven up to Northern Pkwy, Woodbourne)
District 12 (Greenmount east/west up to 25th down, Howard St, to North Ave, to Kirk Ave)
District 14 (Greenmount east/west 26-28th, to Alameda, to Fallsway, Remington, Charles)
I really dont know what district I am in
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Neighborhood
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Phone number
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E-mail
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Preferred contact method
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Phone
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Questions and additional comments
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