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Ask for Help

Giving Kitchen helps food service workers in crisis. The best way to get assistance from Giving Kitchen is to complete this “ask for help” form to determine eligibility for support.


Please finish completing this form in one sitting unless you opt to save your form and resume later. If you leave the form idle for more than 20 minutes, your session will expire, and you will have to start over!

After completion, your application will be reviewed and a case manager will reach out to you, please look for an email or phone call from a GK employee over the next few days. Please make sure to check your voice mail if you do not answer a call from a phone you don’t recognize.


Referrer Contact Details

Before we gather information about the person you're referring, please provide some basic information about yourself below. 


When you get to the end where we collect the personal information of the person you're referring, PLEASE DO NOT ENTER YOUR DETAILS AGAIN. We will need unique contact information for the person in crisis or else this form will not submit correctly and will delay response time.








Important Note:

If possible, we highly recommend informing the individual you're referring to us so they won't be caught off guard when we reach out to them.

Employment Status
Giving Kitchen’s services are only available to qualified food service workers (see criteria below).
Which of the following best describes your employment?
Which of the following best describes their employment?
Giving Kitchen Qualified Food Service Workplaces:
    • Restaurant
    • Bar/Club
    • Brewery/Distillery/Winery
    • Catering
    • Cafeteria (School, hospital, nursing home, office buildings)
    • Concessions (Ballparks, arenas, etc)
    • Food Truck
    • Coffee Shop
Giving Kitchen does NOT currently support individuals working in grocery stores, 3rd party delivery companies (DoorDash, UberEats, etc), and food production companies.
    Workplace Details











    Note: You can search for an address by business name in this field





    We're sorry, but we can only assist food service workers in the United States or US territories at this time.
    We're sorry, but at this time, we can only assist those who worked in the listed food service workplaces.

    Crisis Details

    Now we'll be asking a few questions about their recent crisis. We realize this may be sensitive information and assure you that all information will be kept private.
    Now we'll be asking a few questions about your recent crisis. We realize this may be sensitive information and assure you that all information will be kept private.
    Natural Disaster
    Giving Kitchen has a special program for food service workers facing a federally designated national disaster. If you were impacted by [Disaster Name] click "Yes". If not, please click "No".
    Giving Kitchen has a special program for food service workers facing a federally designated national disaster. If they were impacted by [Disaster Name] click "Yes". If not, please click "No".
    Did your home sustain major damage that made it unsafe to live in?
    Did their home sustain major damage that made it unsafe to live in?
    Are there any other recent crises you have faced that are unrelated to the disaster(s)?
    Are there any other recent crises they have faced that are unrelated to the disaster(s)?
    In the last 6 months, which of the following crises has caused you the greatest financial or physical hardship, including missed work or the potential to miss work?
    In the last 6 months, which of the following crises has caused them the greatest financial or physical hardship, including missed work or the potential to miss work?
    Note: Keep in mind that supporting documents may be requested later for verification.
    Physical Injury

    What is the exact or approximate date that your physical injury occurred?
    What is the exact or approximate date that their physical injury occurred?
    We can only support crises within 6 months of the date of submission
    How many consecutive days did you miss work as a result of your physical injury?
    How many consecutive days did they miss work as a result of their physical injury?
    Physical Illness

    What is the exact or approximate date that your physical illness began?
    What is the exact or approximate date that their physical illness began?
    We can only support crises within 6 months of the date of submission
    How many consecutive days did you miss work as a result of your physical illness?
    How many consecutive days did they miss work as a result of their physical illness?
    Mental Health or Substance Misuse
    Did you receive a new diagnosis or treatment plan that affected your ability to work?
    Did they receive a new diagnosis or treatment plan that affected their ability to work?
    What is the exact or approximate date that you were given the diagnosis or treatment plan?
    What is the exact or approximate date that they were given the diagnosis or treatment plan?
    We can only support crises within 6 months of the date of submission
    How many consecutive days did you miss work as a result of your diagnosis or treatment plan?
    How many consecutive days did they miss work as a result of their diagnosis or treatment plan?
    Inpatient Mental Health
    What is the exact or approximate date that you were admitted to inpatient care?
    What is the exact or approximate date that they were admitted to inpatient care?
    We can only support crises within 6 months of the date of submission
    How many consecutive days did you miss work as a result of your inpatient mental health issue?
    How many consecutive days did they miss work as a result of their inpatient mental health issue?
    Housing Disaster
    What kind of housing disaster did you encounter?
    What kind of housing disaster did they encounter?
    What is the exact or approximate date your housing disaster occurred?
    What is the exact or approximate date their housing disaster occurred?
    We can only support crises within 6 months of the date of submission
    Do you need immediate assistance finding safe housing?
    Do they need immediate assistance finding safe housing?
    Homelessness
    Do you need immediate assistance finding safe housing?
    Do they need immediate assistance finding safe housing?
    What is the exact or approximate date that you became homeless?
    What is the exact or approximate date that they became homeless?
    We can only support crises within 6 months of the date of submission
    Facing Eviction

    Do you need immediate assistance finding safe housing?
    Do they need immediate assistance finding safe housing?
    Death of a Family Member
    Please select your relationship to the person who passed away
    Please select their relationship to the person who passed away

    We can only support crises within 6 months of the date of submission
    We are so sorry to hear about your loss. Would you be interested in grief counseling services?
    We are so sorry to hear about their loss. Would they be interested in grief counseling services?
    Please tell us more about what happened based on the crisis types you selected. Be as specific as possible, and include exactly how much work has/will be missed and any unexpected expenses you are facing.
    Please tell us more about what happened based on the crisis types you selected. Be as specific as possible, and include exactly how much work has/will be missed and any unexpected expenses they are facing.

    Contact Information

    Thank you for this information. Based on your responses, we'd like to provide contact information to a Giving Kitchen Case Manager who can confirm eligibility for assistance and help with next steps.
    Contact Details
    Please provide the contact details of the person that you are referring, not your own contact details.
    Please provide your own contact details, not the details of the recently deceased.






    Numbers only. Do not include any special characters or spaces.







    Numbers only. Do not include any special characters or spaces.

    Have you applied for Giving Kitchen assistance before?
    Have they applied for Giving Kitchen assistance before?
    What best describes why you are applying again?
    What best describes why they are applying again?

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