STL Quarantine Support - Volunteer Form
St. Louis Quarantine Support is a group of volunteers in St. Louis City who are delivering groceries and other necessities so that individuals at highest risk from coronavirus (COVID-19) and those currently experiencing symptoms may remain quarantined.

We are committed to aiding those who are currently sick and those who are preemptively quarantining, especially those who are immunocompromised, those who are 65 or older, and caretakers of these groups.

If you are able to volunteer, please fill out the form below and we will be in touch with more information.
Contact Information
First Name *
Your answer
Last Name *
Your answer
Pronouns
Email address *
Your answer
Phone # *
Your answer
Risk Assessment
Have you traveled outside the St. Louis metro area in the past 2 weeks? *
If 'yes', where?
Your answer
In the past 2 weeks, have you had contact with anyone with a known or suspected diagnosis of COVID-19? *
Do you currently have a cough, fever, or sore throat? *
Grocery Delivery Sign-Up
Delivery volunteers will contact the requester before shopping to confirm their information, pick up the requester's items at the nearest Schnucks, and deliver the items to the requester's address.
Can you volunteer to pick up groceries, medications, and other necessities for people who need to be quarantined? *
Do you have a car or other form of transportation? (You will need to get to and from the grocery store and to and from the requester's house). *
What time(s) of day are you available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
8am-12pm
12pm-4pm
4pm-8pm
Are you able to deliver to the following regions? (Check all that apply)
Phonebank Sign-Up
Phonebankers will call through a list of people to recruit volunteers and assess the needs of people in the community.
Can you volunteer to phonebank? *
What time(s) of day are you available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
8am-12pm
12pm-4pm
4pm-8pm
Volunteer Agreement
I agree not to share the name, address, contact information, medical information, or any other details about anyone requesting services through this group. I understand that I am putting myself at risk, and I agree to take reasonable precautions (e.g. frequent hand washing, social distancing, etc.). *
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