Request for Resources or Referral
Dealing with crises and the daily challenges of systemic racism, gentrification, and xenophobia requires collaborative efforts to bring equity and dignity home to our communities. We are committed to providing our neighbors in Buncombe County with accessible and meaningful support, bilingual information, and resources while building their capacities to work through challenges and advocating for local reform and global change.
**For this form in Spanish, use this link:
https://bit.ly/3e8IdBM
* Required
Date
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MM
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DD
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YYYY
Is this referral for you or for someone else? ***If it's for someone else, select "Other" and write the name of the person it is for.
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Myself
Other:
Required
YOUR name:
*
Your answer
Phone number of person needing assistance:
*
Your answer
May we text this number for information, questions, or concerns regarding the referral request?
Yes
No
Unsure, please call directly and ask
Clear selection
Are you or the person you referred available for a call back from 10 am-3 pm, during the office hours of Consulta Tu Compa? ***If not, select "NO," and write a preferred time in "Other." We will do our best to give a 30-minute consultation during that time.
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YES, available from 10 am-3 pm
NO, I need an appointment outside of the office times
Unsure, please call directly during office hours and ask
Other:
Required
THEIR email address, if available
Your answer
Does the person live in the Emma neighborhood? (There are specific resources for people living in Emma.) If they do NOT live in Emma, select "Other" and write their city below:
YES
Other:
How did you hear about Consulta Tu Compa?
Another organization/agency
Friend/acquaintance
FB/social media
La Milpa (CIMA, RAICES, PODER Emma, Retoño Hnanu)
Other:
Clear selection
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