Lake County Request for Support
Lake County is full of wonderful people willing to help those in need. Please use this form to request assistance due to hardships your household is experiencing due to the impact of COVID-19. Examples of assistance that may be available include but are not limited to: rental/mortgage assistance, utility assistance, emergency food assistance, household supplies, and transportation assistance. Please be sure to enter a working phone number so we can follow up and help connect you to the appropriate supports.

Requests for support are fielded Monday through Friday. If you have an urgent need for support please call 970-445-7325 before noon on Saturday and Sunday.
What is your name?
What is your phone number? *
What supports and assistance do you need? *
Never submit passwords through Google Forms.
This form was created inside of Report Abuse