You can always press Enter⏎ to continue

Eligibility Check (Furniture/Bed Pre-Screening)

Hi there, please fill out and submit this form.
12Questions
  • 1
    Press
    Enter
  • 2
    Press
    Enter
  • 3
    Press
    Enter
  • 4
    Press
    Enter
  • 5
    Press
    Enter
  • 6
    Press
    Enter
  • 7
    Press
    Enter
  • 8

    Based on your previous answers, you may submit a request for furniture assistance by clicking the link below:

    PLEASE CLICK THE BLUE LINK BELOW TO COMPLETE THE FURNITURE/BED REQUEST

    https://form.jotform.com/232125856808057

     

    A confirmation email will be sent to the email you provide on the request form when you submit your request for assistance.

     

    DO NOT CLICK NEXT THIS WILL PREVENT YOU FROM COMPLETING THE REQUEST FORM

    Press
    Enter
  • 9
    Press
    Enter
  • 10
    Press
    Enter
  • 11

    Most of Hamilton County will be served by one of our Conferences, before submitting a request form, please check out our webpage to see if your neighborhood is covered by one of our Conferences:

    Click on the link below to search for out Conferences:

    https://www.svdpcincinnati.org/get-help/

     

    DO NOT CLICK NEXT THIS WILL PREVENT YOU FROM CHECKING OUR CONFERENCE PAGE

    Press
    Enter
  • 12

    Based on your previous answers, you are either not currently eligible for assistance at our Neyer Outreach Center located in Cincinnati, or you need to check our Get Help page on our website to see if you address is covered by one of our Conferences. If you have questions about the instuctions given concerning your next steps feel free to contact our Call Center at 513-421-0602.

     

    Thank You

     

    Press
    Enter
  • Should be Empty:
Question Label
1 of 12See AllGo Back
close