Service Request

Exceptional Hearts is currently providing services to the unhoused and elderly (60+) in Douglas County, GA with anticipation to expand to surrounding counties by the end of 2026.

If you do not meet these requirements, we will gladly connect you to other resources in the area.

If you have a disability and require help with the form, please feel free to call 470-588-5959 and leave a message.

Not answering applicable questions, may cause your request to be denied.

Last name

Phone

Address

Members in Household

Anyone in the home with a physical, intellectual, or developmental disability? (autism, wheelchair bound...)

Ages of all household members.

What are you in need of?

Food

Toiletries

Are you over the age of 60? (Proof of age will be required)

Yes

Are you experiencing homelessness? This can include not having a place to sleep, living in a shelter, car or on the streets, couch surfing, and/or living in a motel.

Yes

Douglas County, GA Resident Acknowledgement

By checking this box, I acknowledge that I am a resident of Douglas County, GA.

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