Service Request

Exceptional Hearts is currently providing services to

the unhoused and elderly (60+)

in Douglas County, GA.

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 (MUST BE IN DOUGLAS COUNTY)*

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 (Unhoused ONLY)

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

Yes

Are you unhoused?

Yes

What is your current situation?

Sleeping in a car

Living on the street

Douglas County, GA Resident Acknowledgement

By checking this box, I acknowledge that I am a resident of Douglas County, GA. If you are not a Douglas County resident, please search FindHelp.org for assistance in your county.

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Exceptional Hearts INC.

We are a registered 501c3 organization with the state of Georgia. All donations are tax deductible.

Email: help@exceptionalheartsinc.org

Phone: 470-588-5959

Registered Charity: 93-2624365

Hours of Operation

Monday - CLOSED

Tuesday – Friday, 10am-5pm

Saturday - 9am-12pm (Deliveries only)

Sunday - CLOSED

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