Wickhambrook PC COVID-19 Response Survey

In need of assistance

Please let us know if you, or anyone you know of in the village, need assistance at this time. We'll only keep contact details for this purpose.

Name

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

A family member

Someone I know

Sole occupant

Reliant on sole carer

No transport

Relian on mobility aids or equipment to move around home

Reliant on one source of energy for heating and cooking

Have been designated by NHS as person to be shielded

Reliant on others for cooking and cleaning

Reliant on others for groceries and medication supplies