Request Assistance
Complete this preliminary inquiry and our team will follow up with next steps. Submitting this form is not an application and does not guarantee assistance.
Before You Begin
- Assistance may be available to qualifying households based on documented need and subject to available funding.
- All requests are reviewed subject to eligibility requirements.
- Please never send Social Security numbers, bank account details, card numbers, or account passwords through this form.
- If you are in immediate danger, please contact local emergency services or dial 911.
- Questions? Call (915) 731-6729 or email info@impactusoftexas.org.