If you (or the person potentially at risk) is experiencing an emergency, please do not fill out this form. Instead, pick up your phone and dial 911 for assistance.
As you may be aware, the Pocket Community Association (PCA’s) COVID-19 Committee is gathering volunteers throughout The Pocket to help others in this time of need.
Our wonderful community is filled with people from all walks of life and a wide range of abilities. Some challenges or struggles are shared or obvious, while others are hidden or largely invisible.
As such, we would like to identify people in The Pocket who wish to identify themselves (or others in The Pocket) to the "PCA COVID-19 Committee" as a “person at risk”. NOTE: You DO NOT need to be a resident of The Pocket neighbourhood to make a referral FOR a person in The Pocket.
You’re probably asking yourself, "What do we mean by a ‘person at risk’?" There are no specific criteria–it’s whatever you think the criteria are in this time of need. Maybe you consider yourself at risk because of a health issue or another reason. Maybe you live alone and would like someone to call you every day or two. Maybe you’re concerned about a person next door, someone in the basement apartment across the street or a senior around the corner, perhaps because their family isn’t available to help. Whatever it is, maybe you’re right.
Some people won’t ask for help. Some won’t think they’re at risk or accept help. Others will be thankful someone cares and accept some help.
The purpose of this form is to help the PCA COVID-19 Committee identify people whom we should try to reach out to or check on as this crisis evolves. We’re not a substitute for emergency medical services or healthcare professionals, but we’ll try to help.
As an alternative to filling out this form, you may call the PCA's COVID-19 helpline at 416-848-0977 and leave a voicemail to help us identify a person potentially at risk.
If you would like to identify someone potentially at risk, complete the information below. A member of the PCA COVID-19 Committee will review it and consider how we might be able to help.
The PCA is collecting this information for the purpose of identifying people who are potentially at risk and assisting them and will use it only for this purpose. All copies of the form will be securely destroyed after this period.
Please keep in mind that we will respond as soon as possible and that this is not an emergency service.
* Fields marked in RED are required fields to be completed.
Please complete as much of the information as you can. This form can be filled out by either the person at risk (which is you if you consider yourself at risk) or a neighbour wishing to identify someone they feel is at risk. As such, the form has two contact records that can be completed–for the person potentially at risk and the person completing this form.