Let us know if you are in need of help or support during the coronavirus (COVID-19) pandemic.

  1. Label
  2. Your Details
    1. Address lookup
  3. Name and Address of Person needing support
    1. Address lookup
    2. Do you know which ward this address is in? This will help us keep Councillors informed about people in their area.

    3. Has anyone in the household received a letter from the NHS requiring them to self-isolate for 12 weeks?

    4. Please select the help/support needed*
    5. If 'Other' was selected, please describe the nature of assistance required.

    6. Some of the support groups offer help to certain age ranges or have more experience dealing with certain people. It would help if you were able to select the appropriate age range from the list below.

    7. Is there anything else you think would be helpful for us or a volunteer to know?

    8. Data Sharing

      I agree that personal data relating to me, including the data given on this form, may be held and processed by West Devon Borough Council on computer or manual records. I understand that my data may be disclosed to local community groups responding to the coronavirus (COVID-19) response, who are involved with the coordination of volunteer services. I understand that these groups are not affiliated with West Devon Borough Council and that West Devon Borough Council is not responsible for the services they provide. I agree that these organisations can contact me.

    9. Data Sharing

      I agree that personal data relating to me, including the data given on this form, may be held and processed by South Hams District Council on computer or manual records. I understand that my data may be disclosed to local community groups responding to the coronavirus (COVID-19) response, who are involved with the coordination of volunteer services. I understand that these groups are not affiliated with South Hams District Council and that South Hams District Council is not responsible for the services they provide. I agree that these organisations can contact me.

    10. Where I have provided details of another person who I believe to be in need of support or assistance, I understand that West Devon Borough Council will use the information I have provided to contact this person in order to establish if they require assistance. West Devon Borough Council will also ask the person whose details I have provided if they agree to their data being shared with local community groups. My personal data will not be shared with this person, nor their data with me.

    11. Where I have provided details of another person who I believe to be in need of support or assistance, I understand that South Hams District Council will use the information I have provided to contact this person in order to establish if they require assistance. South Hams District Council will also ask the person whose details I have provided if they agree to their data being shared with local community groups. My personal data will not be shared with this person, nor their data with me.

    12. I have read and understand the data sharing statement: