Hammersmith and Fulham Mutual Aid Support Requests
If you or someone you know is in need of support due to COVID-19 please fill out this form. This is a grassroots, locally organised mutual aid group aiming to support our community, all support will be provided by volunteers. Please be aware the volunteers may not be DBS checked and likely have not had any formal training in providing care. Please take basic precautions (e.g. don't invite them into your home)
Who are you requesting help for?
Clear selection
Your name *
Your email *
Your phone number *
Name of the person you're requesting for *
Phone number of person you are requesting help for (if different)
Street/road (if you are requesting help for another person please put their street here)
Ward (if you are requesting help for another person please put their ward here) *
We are only able to offer help in the wards named below, however we may be able to put you in touch with other groups
Support needed? *
Required
Urgency *
Do you (person receiving help) have any specific requirements such as diet, access or communication?
Are you happy for us to share your request with the council? *
We will always make an effort to ensure a local response however in some cases it may be safer for both you and the volunteer for the council to offer support. We will never pass your information to the council or any other organisation without your consent. If you are uncomfortable with this happening we will still ensure you receive the support required.
Is this a referral from CAN?
CAN reference number (if relevant)
Submit
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