2010 Flood Needs Assessment
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1. NEEDS ASSESSMENT

First Unitarian Universalist Church of Nashville
FLOOD RELIEF SURVEY 2010

We are making an effort to assess the immediate and longer term needs of our congregation in the aftermath of the recent flood. We want to be able to provide whatever assistance is available including the recently established UUA Tennessee-Kentucky Emergency Flood Relief Fund. PLEASE TAKE SOME TIME TO COMPLETE THIS SURVEY FORM AND FEEL FREE TO UPDATE IT FROM TIME TO TIME AS YOUR SITUATION CHANGES OR BECOMES CLEARER.

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1. Name

Name

2. Address

Address

3. Telephone Numbers

Telephone Numbers

4. Email address

Email address

5. Food resources needed

Food resources needed

6. Transportation needed

Transportation needed

7. Health Care (replacement of glasses, medical items, prescription medications)

Health Care (replacement of glasses, medical items, prescription medications)

8. Counseling Assistance

Counseling Assistance

9. Dependent Care ( infants/youth, eldercare)

Dependent Care ( infants/youth, eldercare)

10. Pets (displaced due to flood)

Pets (displaced due to flood)

11. Other needs

Other needs

2010 Flood Needs AssessmentExit this survey