Protected: Intake Assessment Form

The Intake Form is operated by Tyler County Family Resource Network

We respect your privacy and are committed to protecting the information you share with us.

Information We Collect

We collect only the information you voluntarily provide when completing this Intake Form. This may include:

• Your name
• Contact information (phone, email, address)
• Details about your needs (such as housing, food, utilities, transportation, or other assistance)
• Optional demographic or location information to help connect you with appropriate services

Providing personal information is voluntary; however, incomplete information may limit our ability to assist you.

How We Use Your Information

Information submitted through this form is used only to:

• Respond to your request
• Connect you with appropriate service providers in Tyler County, West Virginia and surrounding areas
• Coordinate assistance with trusted partner organizations

We do not sell or share your personal information for marketing or commercial purposes.

When We May Share Information

Your information may be shared only:

• With trusted local partner agencies to help meet your request
• In non-identifiable, aggregated form to improve services or support funding efforts
• When required by law

Data Protection

We take reasonable measures to protect your information and limit access to authorized personnel only. While we work to safeguard your data, no system can guarantee complete security.

Your Rights

You may:

• Request to update or correct your information
• Request deletion of your information
• Decline to provide certain details

To request changes or ask questions, please contact:

Tyler County Family Resource Network
Tylercountyfrn1@gmail.com                                                                                                                          Address:  PO Box 187 Middlebourne, WV  26149