SSN COVID-19 Request for Assistance Form
Last updated: 19 August 2020 10:45
Have you already registered as a community member with the SSN COVID-19 Samford Response service and have a CID number?

Your registered community member details are:

    Community Member ID is: CID
    Name:
    Address: , ,
    Phone:
    eMail:
Please now complete the information below.

What type of assistance do you require?
Are you in COVID related isolation or quarantine?
Essential Food Delivery Service

Important: Please read the following information about this service:
  • If you are in financial stress as a result of COVID-19, please consider applying for our No-Charge Essential Groceries Shopping Service to available eligible community members.

  • All orders received before noon we aim to have delivered the following delivery day (currently Wednesdays and Fridays). However we may take up to 48 hours to deliver depending on Volunteer availability.

  • We aim to make deliveries between 8am and 12 noon and if no one is home and we can’t contact you for immediate delivery, we reserve the right to leave your shopping on the doorstep or the designated dropoff place.

  • We are currently only providing up to 15 single items per shop and one order per household per 7 days. This is reset at midnight every Sunday. You currently have shops left this week. Please choose what is essential to you.

  • An item can be a bag of fruit or vegetables. Please specify 1 in the quantity and the number or weight in the description (for example, "1 x bag of 6 red apples" or "1 x bag of green grapes" or "1 x 5kg bag of potatoes)".

  • All items must be available from Drakes Supermarket Samford. Drakes currently have restrictions in place to limit hoarding - please click here for details.

  • We reserve the right to substitute items if your requested one is not available, or to not get any particular item at all.

  • Goods will be delivered in plastic bags (for which you will be charged) with a receipt inside and details of how to pay the bill. Please pay promptly. Unpaid bills will result in a polite follow-up!

  • The SSN may obtain donations from Drakes Supermarkets as a result of our volunteer shoppers using the Drakes Community Dollars key fob during check out of your shopping.

  • Social Distancing and strong disinfecting techniques will be used by our Volunteers.

  • Please do not approach or invite our Volunteers inside your home.

  • All Volunteers will have Yellow SSN COVID-19 Samford Volunteer ID badges.

  • We are all unpaid Volunteers working under very difficult conditions – please don’t abuse or criticise personally or via social media.

  • If you have any issues please contact the SSN COVID-19 Samford Response email or phone number and we will endeavour to assist.
No Charge Essential Groceries Service

Important: Please read the following information about this service:

  • You have advised that you are in COVID related isolation. Our Volunteers will do your shopping and deliver it to you as outlined below. If you are able to do your own shopping without breaching isolation rules, we can alternatively provide Drakes Gift Cards to you. Please select No to the above question if you wish to do your own shopping using Drakes Gift Cards.

  • Your free entitlement is for separate orders of 15 single items per household per 7 days. This is reset at midnight every Sunday. You currently have shops left this week. Please choose what is essential to you.

  • Please ensure that you advise us immediately if your circumstances change that may affect this allocation (up or down).

  • All orders received before noon we aim to have delivered the following delivery day (currently Wednesdays and Fridays). However we may take up to 48 hours to deliver depending on Volunteer availability.

  • An item can be a bag of fruit or vegetables. Please specify 1 in the quantity and the number or weight in the description (for example, "1 x bag of 6 red apples" or "1 x bag of green grapes" or "1 x 5kg bag of potatoes)".

  • All items must be available from Drakes Supermarket Samford.

  • We reserve the right to substitute items if your requested one is not available, or to not get any particular item at all.

  • Goods will be delivered in plastic bags (for which you will be charged) with a receipt inside and payment details. As your shopping is free, please disregard any requests for payment!

  • All orders received before noon we aim to have delivered the following day. However we may take up to 48 hours to deliver depending on Volunteer availability.

  • We aim to make deliveries between 8am and 12 noon and if no one is home and we can’t contact you for immediate delivery, we reserve the right to leave your shopping on the doorstep or the designated dropoff place.

  • Social Distancing and strong disinfecting techniques will be used by our Volunteers.

  • Please do not approach or invite our Volunteers inside your home.

  • All Volunteers will have Yellow SSN COVID-19 Samford Volunteer ID badges.

  • We are all unpaid Volunteers working under very difficult conditions – please don’t abuse or criticise personally or via social media.

  • If you have any issues please contact the SSN COVID-19 Samford Response email or phone number and we will endeavour to assist.
No Charge Essential Groceries Service (Drakes Gift Cards)

Important: Please read the following information about this service:

  • In order to reduce the load on our Volunteers, and to give you more freedom and ease for your personal shopping, we have introduced Drakes Gift Cards for households who are not in COVID related isolation.

    As you have advised you are not in COVID related isolation, you are able to do your own shopping using the Drakes Gift Cards that you can order (at no charge) below.

    If you are unable to shop yourselves for any reason other than COVID related Isolation, please advise the SSN COVID Response team ASAP.

  • Your free entitlement is for x $50 Drakes Gift Cards per household per 7 days. This is reset at midnight every Sunday.

    You currently have x $50 Drakes Gift Cards left this week.

  • When your requested Drakes Gift Cards are ready for collection you will be notified via SMS or email. This may take up to 24 hours AFTER your order has been placed depending on Volunteer availability.

  • Once notified, you can collect your Drakes Gift Cards from the SSN COVID Samford Response Office located at Unit 2/7 Main Street, Samford Village (next to Mooeys) between 7am and 10am on the following delivery day (currently Wednesdays and Fridays). However we may take up to 48 hours to deliver depending on Volunteer availability.


  • Government Photo ID will be required, including confirmation of address (eg Drivers licence).


  • Please respect Social Distancing and use hand sanitiser before or when entering the office.

  • Please ensure that you advise us immediately if your circumstances change that may affect this allocation (up or down).

  • These Gift Cards must only be used at Drakes Supermarket Samford.

  • On checkout, please ask the cashier to scan the Samford Support Network Community Dollars barcode. This provides a small donation back to the SSN.

  • We are all unpaid Volunteers working under very difficult conditions – please don’t abuse or criticise personally or via social media.

  • If you have any issues please contact the SSN COVID-19 Samford Response email or phone number and we will endeavour to assist.
What is your preferred delivery date?
Note that we cannot guarantee delivery at any particular date and time, but we will try and accommodate your request.
Will you accept substitutes due to non-availability of any item?
Total Items: 
Store:  Your Shopping List - MAXIMUM OF 15 ITEMS ONLY:
 Please specify how many $50 Drakes Gift Cards you require: x $50 Drakes Gift Cards
Additional information for the Shopper.
Pharmacy Delivery Service

Terry White Chemmart Samford are currently able to deliver medication using their in-house team.

If you require medication, please order and pay for your items by contacting the Pharmacy directly by calling 07 3289 1559, sending an email to Samford@TerryWhiteChemmart.com.au or by ordering through MedAdvisor.

We are working with the team at Terry White Chemmart Samford and if requested by them we will organise delivery of your pharmaceutical items.

Psychological and Emotional Support Service

For urgent assistance please see our information page at Urgent Assistance.

COVID-19 is putting a huge strain on many of us, but help is available.

For psychological and emotional support please call the Samford Support Network on 0470 214 916 and we will arrange for someone from our Psychology and Client Support Group to call you back.

Alternatively, Please refer to our urgent assistance information page at Urgent Assistance.

Normal SSN Services

Most of our normal Samford Support Network Services are still operating, albeit in a reduced capacity where COVID-19 constraints apply.

Please refer to our SSN main web site for details of the services offered.

If you need to contact the SSN please email ssn@samfordsupportnetwork.com or call 0470 214 916.

We Need YOU!

For details of how you can help us, please refer to our Volunteer Application Form.

Frozen meals from Meals on Wheels

We can provide a variety of frozen meals prepared by Meals on Wheels to community members that are sick or injured and unable to cook for themselves.

Please order on the Essential Food Delivery service and quote either MOW soup or MOW main meal and the required quantites.

General COVID-19 information

We strongly recommend only following information provided by Government sources.

Queensland Government, Queensland Health – Coronavirus Fact Sheet.
Australian Government Department of Health – Novel Coronavirus Health Alert.

Have a different question?


If you have a question about the SSN COVID-19 Samford Response that we haven't answered on our Frequently Asked Questions or our web site, please either email us on COVID-19@samfordsupportnetwork.com or call our SSN COVID-19 Samford Response number on 0492 886 612 and we'll try our best to help or refer you to someone who can.