Pitt Mutual Aid Delivery Form
Hello!

Thank you for reaching out to us! We are happy to help you out! Please provide us with the following information, and we will find someone to deliver to you as soon as possible!

For your safety, please review our guidelines for cleanliness and risk reduction for deliveries below!
Email address *
Safety Instructions for Recipients:
Instructions for Recipients:
Unpack groceries while being careful not to touch your eyes/mouth/face
Wash fruits, vegetables, and any non-porous containers with soap and water
After unpacking groceries, clean and disinfect counters and thoroughly wash your hands with soap and water for at least 20 seconds

Reimbursement:
It is preferable for recipients to reimburse the cost of goods through digital payment methods such as Venmo or CashApp in order to limit contact. If this is not possible, and it is necessary to use cash or a check, please follow this protocol:

Volunteer contacts recipient via text or phone call to confirm that it is ok to approach their door. Volunteer drops off goods outside of the recipient’s door, then backs up at least two meters away from the front door. Volunteer contacts recipient to tell them they have arrived.

The recipient opens the door and receives goods. Recipient places payment (preferably in an envelope) outside the door. The recipient closes the door bringing goods with them.
Recipient confirms via text or phone call that it is ok for the volunteer to approach the door.

The Volunteer approaches the door and picks up payment. The Volunteer confirms receipt of payment via text or phone call and leaves.


Other tips:
Stock up on non-perishable items and other items with a long shelf life to decrease the frequency of deliveries to minimize exposure risk
I have fully read and acknowledged the instructions above. *
Name *
Phone Number *
Delivery Pick Up Store/Location/Address (Be Specific) *
Delivery Drop Off LocationAddress (Be Specific) *
Items Requested (Be specific. If prescription medication, please provide your DOB. You do not have to tell us what the medication is, but please inform us if it is a controlled substance.) *
Payment Method *
Payment Method Username (If cash, please use "n/a") *
Specific Time needed? (Example: By April 22nd at 12pm. "N/a" if none) *
Would you like financial assistance with covering the cost? *
Additional Details?
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