ChristChurch COVID-19: Needs & Response Survey
If you need help or are able to help the community in this health crisis, please fill out this survey to tell us what your needs are or how you can help respond to the needs in our larger community.
Please check all that apply. If you have questions email
Admin@comchristchurch.org
* Required
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
I or someone I know needs help with:
Getting groceries or other essentials
Picking up and delivering drug prescriptions
Receiving face masks
Connecting online, getting setup with Zoom, etc.
Transportation to medical appointments
Other:
I would appreciate a phone call to further discuss my needs or needs of people I know.
Yes
No
I can help with.....
Shopping for groceries
Delivering groceries ordered on line
Picking and delivering drug prescriptions
Sewing face masks
Technical assistance to help people stay connected online
Transportation to medical appointments
Other:
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