I NEED HELP — #nbmacan

Help for New Bedford.

There is help in New Bedford for you. We are here to help you find it. Please fill out this form with as much information as you can. This information is crucial for us to respond as quickly as possible, as well as to have the correct person contact you.

Please fill out this form as best as you can and we will follow up with you very soon!

Name

First Name

Last Name

Phone

(###)

###

####

Select

I prefer to be contacted by

I need help in the following area

please select

If you selected "Basic Needs," please tell us what type of basic needs you are seeking.

please mark all that apply

Transportation

Picking up my prescriptions

Delivery of groceries or other needed supplies

Other

If you checked "other," please explain

If you are seeking help, which New Bedford neighborhood do you live in?

please select

If you marked "other," please tell us where you live

Are you fluent speaking English?

please select

If no, which language are you fluent in?

please share

Is there anything else about your circumstance at this time that if we knew would allow us to help you faster and in a more complete way?

If so, please explain.

“No one needs to be left finding help on their own. No one needs to walk through a crisis by themselves. No one needs to feel like they have no one in their corner who cares. We are here. We care.”

#nbmacan