Contact Information and Services Available in Respond to the COVID-19 Virus
Please provide us with your agency's information so we can keep everyone up today on how to reach services at your agency during the pandemic. We are hoping to have a spreadsheet available to all of our services providers so they can effectively refer people for services and what the best way people access those services so we avoid frustration for client's seeking services. This spreadsheet will be available to you once you complete the survey.
Email address *
Name *
Agency's Name *
Is your agency open to in person services *
If you agency is NOT open to in person services, please let us know how can people apply/access services *
1 point
Please list your hours of operations *
If you agency is changing the services they provide, please let us know what changes are taking place. *
Please provide the approximate date that your agency will follow this plan. Please provide it below, or if you don't know please state so. *
Never submit passwords through Google Forms.
This form was created inside of Lakeshore CAP, Inc..