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Family Resources & Connections Survey
We care a lot about Rowe families and want to be helpful where we can. Please fill this out to be connected with community resources.
You can also always reach out to Rowe's Social Worker or a Counselor at any time
, and get more information from our District Resource Guide here:
https://docs.google.com/document/d/1rbxmtJ1BqoS3vueD_erxlEvcTA3aQO_EZsN147zdWg4/edit
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* Indicates required question
Email
*
Your email
What is your full name?
*
Your answer
Who are your kids / students at Rowe?
*
Your answer
Best phone number?
*
Your answer
How do you prefer we communicate the information? (select all that work)
*
Email
Phone call
Text
In-person meeting (please call me to schedule)
I'll stop by Rowe when it's convenient
Required
I would like to learn more about opportunities to get support with (check all that apply):
School Supplies (notebook, pencils, etc.)
Holiday gift support (over Winter Break)
Mental Health services for my kids
Mental Health services for adults
Housing
Rental / utility assistance
Food pantry info
Backpack Buddies program (so my kid can get a bag of food at school to bring home every other week)
Clothing for my kids
Internet help, Hotspot
Enrolling my child in Oregon Health Plan
Health insurance options for adults
Medical Care for my kids (without insurance)
Dental Care for my kids (without insurance)
Glasses or eye care for my kids (without insurance)
Immigration services or support
Indigenous / Native American specific resources and support
Black / African American specific resources and support
Latino / LatinX specific resources and support
Pacific Islander / Native Hawaiian specific resources and support
Russian / Ukrainian specific resources and support
Non-food pantry items (household supplies, cleaning supplies, toothbrushes, etc.)
Diapers/wipes
Employment assistance - job searching, training resources, unemployment, etc.
After school activities
Tutoring support for my kid
Parenting support
Domestic Violence support (discrete and confidentially)
Support with suicidal thoughts (myself or kid)
Drug and Alcohol support or treatment for my child
Drug and Alcohol support or treatment for an adult
Mentoring and support for my child who has had a family member in prison
LGBTQ+ resources (for my child, myself, or my own learning)
Other:
What language do you prefer getting the information in?
*
English
Spanish
Russian
Vietnamese
Other:
I could use this information, or to at least connect with someone:
Immediately, or as soon as possible
Within 2-3 weeks
No rush, I'll reach out if it becomes urgent
Other:
Clear selection
Is there anything else you'd like us to know, or do you have any questions?
Your answer
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