Schedule an Appointment Laundry Services Today's Date - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Case Manager The Case Manager/Social Worker completing this form must provide the following information so the Hospitalities Coordinator can contact if there are any questions or concerns.Case Worker/Social Worker Name First Last Case Worker/Social Worker DepartmentCase Worker/Social Worker Phone Laundry Services Drop Off Participants may drop-off no more than 2 grocery-sized bags full of clothing to be washed and dried. Your Case Manager will let you know when your items will be READY for PICK UP. For safety, all laundry will be washed in hot water. Please keep this in mind, should you have clothes that are delicate or should not be washed in hot water with light colors. You must pick up your laundry on the day your Case Manager gives you. After ONE week, ALL unclaimed clean laundry will be folded and added to the Clothing Closet.Name * Required First Last Address ZIP / Postal Code Best Way to Contact You * RequiredPhoneEmailPhone * RequiredEmail * Required Enter Email Confirm Email How did you hear about us? Search Engine (Google) Print Family/Friend Health Care Provider Organization Other EmailThis field is for validation purposes and should be left unchanged.