Name * First Name Last Name Email * Phone (###) ### #### Communication Preference Call Text Email Best Time to Reach Evening Daytime Weekends Weekdays Anytime Housing Location (Town, State) * How did you hear about Vermont Access to Reproductive Freedom? * Do you have any questions about the work that Vermont Access does as an abortion fund? * VT Access in the early stages of partnering with other practical support networks and legal experts to provide housing as safely as possible for all folks involved. Typically, patients would need 1 or 2 nights during the week–it is unlikely that any weekend lodging would be needed. VT Access is working towards creating a list of safe housing options to share with clients who call us directly– this list would not be online and would not include your last name or address. VT Access will be sure to share their exact process with you prior to launching this service and will be seeking feedback to make sure this feels comfortable for all parties. Any questions, preferences or thoughts about this? * VT Access would love to learn about you if you’re comfortable sharing– this could be more information about your interest in helping with this work, any past experience that is relevant to hosting, your day job, how long you’ve been in Vermont–really anything you’d like to share! * Please share more details about the space you’re able to offer to patients: * Ex: number of bedrooms, room within a home, entire private apartment, parking on-site, access to public transportation, etc. How frequently would you be interested in hosting patient? * Ex: as much as is needed, once a month, once a year, etc. What would be the best process for connecting you to potential guests? (e.g., via phone call, text, or another way) * How much advance notice would you need for sharing your space? * VT Access primarily uses a secure app called Signal to communicate about this service. Would you be open and able to download this app? * Is there anything else you’d like VT Access to know or any other questions at this time? * Thank you! Offer Short-Term Housing for Women Seeking CareSign up to be a volunteer host for women visiting Vermont to receive the medical treatment they can’t get at home. Your submission form will be submitted directly to the staff of Vermont Access. If you have questions, please contact Vermont Access directly.
