COVID-19: Individual Resource Requests
Please fill out this form if you are a Howard County resident with needs related to COVID-19. Please note: submission does not guarantee delivery of resources.

***PLEASE NOTE: THIS FORM IS NOT TO BE USED FOR MEDICAL RESOURCE REQUESTS. NO MEDICAL EQUIPMENT WILL BE FULFILLED THROUGH THIS FORM.***

Do not use this form for Homemade Mask Requests. Use this form: https://forms.gle/WASNeEwtkzfp9BnT8
Name *
Email
Phone *
Address (will be kept confidential) (must include House number, street, town, and zip code) *
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