Assistance Request Form

Mending Roots provides compassionate, individualized assistance to people and families facing hardship. Please share your circumstances and the help you are requesting. We understand that asking for help can be difficult and will treat the information you provide with care and respect.

Our team will review your request and may contact you for more information. Every request will be considered thoughtfully based on individual circumstances and available resources; submitting this form does not guarantee assistance. If you need help completing this form, a Mending Roots representative or partner organization can complete it with you.