May 1, 2026 Storm Assistance Request Form

May 1, 2026 Storm Assistance Request Form

Please provide your details and select the support services you need. Note: Assistance is not guaranteed.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Have you already been connected with the American Red Cross?*

YesNo
Are you or someone in your household elderly?*

YesNo
Please select the types of assistance you are requesting that stem from the May 1, 2026 storm:*

Tree branch removalMental health supportLong-term case management supportOngoing food assistanceOther
Please explain your other assistance needs
Submitting this form does not guarantee assistance. Support will be provided based on available resources and need.
Should be Empty: