Thank you for reaching out to our program.

Our goal is to support expecting and new parents by providing maternity clothing, postpartum recovery supplies, baby essentials, education and connections to community resources.

Supplies are provided at no cost and are distributed based on availability.

The questions on this form are not intended to discriminate against you or your family.

I understand that:

• Supplies are distributed based on availability.
• Completing this form does not guarantee that all requested items will be available.
• Certain items, including car seats and breast pumps, may only be distributed if they meet current safety standards, funding requirements and program eligibility guidelines.
• The information I provide may be used, without identifying me personally, for grant reporting, program evaluation and community planning. This information also helps Public Health:

• Better understand the needs of families in our communities.
• Improve future funding opportunities.
• Ensure resources are distributed fairly.
• Connect families with additional programs and services they may qualify for.
• Identify gaps in services to strengthen community support.

Information collected may be reported only in aggregate for grant reporting and community planning. Personal information will remain confidential to the extent allowed by law.

These questions help us identify urgent needs.