Commission Resource Request Form
Use this form to request assistance from the Commission. We provide help in areas such as advocacy, referrals for legal assistance, connection to gender-affirming care, and other resources that promote the wellbeing and safety of LGBTQ+ individuals across the Commonwealth. As a youth serving organization, we are prioritizing requests made by those who fall under our classification of youth (under 26 years of age). We will require verification of your age--however this information will be kept confidential and will not be distributed.Please share as much detail as you feel comfortable providing so our staff can connect you with the appropriate resources or follow up to learn more. All information submitted through this form will be kept confidential and used only for the purpose of responding to your request.
Email
example@example.com
What areas do you need assistance in?
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Advocacy
Food Resource
Gender Affirming Care Resource
Community Resource Connections
Other
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Advocacy
Please Briefly Describe Your Need (ex: referral for legal assistance, name change, help in your school, housing referrals/resources, etc)
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Food Resources
Do you have access to a place to prepare food?
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Yes
No
What is the closest grocery store to you?
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Gender Affirming Care Resource
Please Briefly Describe Your Need
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Community Resource Connection
Please Briefly Describe the Resources You Want Connections To
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Contact Info
Contact Name
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What is your age?
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Where are you located?
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Preferred Contact Method
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Email
Phone
Social Media
Preferred Contact Info:
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Any additional info you would like to share
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Submit
Should be Empty: