Southside self-isolation support request
If you're in self-isolation and need some support, please use this form to let us know what you need and we'll connect you with a local volunteer if we're able to help. Please note, we will share your contact details with your assigned volunteer to allow you to make arrangements between yourselves.
Name *
Mobile number *
Email address *
If you don't have an email address, please add the email address or number of someone else we can contact in case of any issues getting in touch.
Have you been confirmed as having coronavirus (COVID-19)? *
Do you have symptoms or are you self-isolating as a precaution? *
What help do you need? Please give as much detail as you can. *
Are you able to transfer any money required via internet banking or bank transfer? *
(If you can't we can still help, but transfers are the safest option - we can provide technical support on how to do it if you need it.)
Postcode *
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