- Complete this form (below) online and submit to our Intake Department **** PLEASE NOTE, IF THIS FORM IS NOT COMPLETE, IT MAY DELAY POSSIBLE SERVICES***
- ALSO, THE ADDRESS PROVIDED ON THIS FORM HAS TO BE THE ADDRESS WHERE YOU NEED THE HELP. IF YOU ARE MOVING SOON, YOU NEED TO WAIT UNTIL YOU ARE MOVED AND THEN SUBMIT YOUR REQUEST.
- Intake staff will either return your e-mail or call and discuss your request if further information is needed.
- If a referral is able to be made, a SVDP volunteer will call you within 1 - 3 weeks to arrange a home or phone visit and meet with you about the item(s) requested.
- If you are unable to complete this form, you may call 414 462-7837, extension 110. You do not need to call if you have completed this form.
All information provided is held in strict confidence and is never shared with any other agency.
We offer our healing prayers to you and your family and will be in touch as soon as possible!