Mama Needs A Hand Application
The Nu You Inc is thrilled to serve 1,000 moms in Prince George’s County through The Mothers First Initiative in partnership with Community on the Frontline and Councilwoman Krystal Oriadha. This expanded effort allows us to bring meaningful, on-demand support to mothers during pregnancy, postpartum, and early motherhood. Please read the terms and conditions for all the details about “Mama Needs a Hand.” While we may not be able to serve every mom immediately, our goal is to meet as many needs as possible.We are putting mothers in the center of care.
Full Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Method of Contact
Phone
Email
Text
Family Information
Do you have children? (If yes, proceed to the next questions within this section.)
Please Select
Yes
No
If yes, proceed to the next questions.
Which best describes you?
Mom
Legal Guardian ( Woman)
How many children do you have?
What are the ages of your children?
Do you have any pets? If so, what kind?
What's your shirt size? Just in case we want to leave you a gift :)
Do any of your children have special needs or require additional support? If yes, please provide details.
Current Challenges
What is your primary reason for applying for the "Mama Needs a Hand" service?
What specific challenges are you currently facing as a mom? (Select all that apply)
Lack of childcare
Financial difficulties
Limited support system
Physical or mental health concerns
Other
If other, please specify.
What day of the week would you like to be served? Click the preferred day(s)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Have you experienced any significant life events in the past year that have impacted your well-being or your ability to care for your children?
On a scale of 1–5, how overwhemled do you currently feel in your role as a mom?
Not overwhelmed
1
2
3
4
Extremely Overwhelmed
5
1 is Not overwhelmed , 5 is Extremely Overwhelmed
Support Needs
Which areas of support would you benefit from the most? (Select all that apply)
Childcare
Household tasks (e.g., cleaning, light house tasks )
Emotional support
Mental Health Support
Organizing
Bedtime Routines/Family Schedule
Postpartum Support
Other
If other, please specify.
How often would you need assistance?
One-time assistance
Weekly
Bi-weekly
Monthly
What time of day do you typically need the most support?
Morning
Afternoon
Evening
Eligibility and Commitment
Do you have a reliable mode of communication for coordinating service with the Mom assistants(e.g., phone, email)
Are you willing provide pre and post survey based on experience?
Yes
No
Additional Information
Have you received assistance from “Mama Needs a Hand” or similar services in the past?
Yes
No
If yes, please provide detail.
Is there anything else you would like us to know about your situation or how we can best support you?
How did you hear about this service?
Instagram
Threads
Facebook
Family member or Friend
Local assistance program
District 7
Community on the Frontline
Other
Consent and Agreement
*
*
Signature
*
Continue
Continue
"Mama Needs A Hand"
We are thrilled to support 1,000 moms in Prince George’s County through The Mothers First Initiative in partnership with Community on the Frontline and Councilwoman Krystal Othide. This expanded effort allows us to bring meaningful, on-demand support to mothers during pregnancy, postpartum, and early motherhood.Please read the terms and conditions for all the details about “Mama Needs a Hand.” While we may not be able to serve every mom immediately, our goal is to meet as many needs as possible and brighten the days of mothers across the county as this initiative grows.Applications will be reviewed starting on 2/24/25. .
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