Central Virginia Health District Assistance Request Form

ONE FORM – ENDLESS CONNECTIONS

Amherst, Appomattox, Bedford, Campbell, & Lynchburg Residents- Submit an Assistance Request Form today!

The Central Virginia Health District’s Community Health Workers monitor this referral form daily.

All submissions will receive a response within 2 business days. By completing the Assistance Request Form, individuals can be connected to a wide range of services, including Maternal & Child Health Services, Clinic Services, & more.