WBRC Service Status Update Form

Well Badger is committed to maintaining an up-to-date, accurate, responsive database of health services. If your program has experienced changes due to COVID-19 - such as reduced hours or suspension of in-person services, please fill out this brief survey to let us know, so we can update our online directory.

1. Please provide the following information (Required fields) *This question is required.

Organization
City
Program /Service Name

2. If your program has COVID-19 related changes or instructions, please enter them below. What you enter here will appear in a special, temporary field on your program page in the Well Badger Directory. (Required field)

Example: Program ABC has reduced hours (9:00 AM - 2:00 PM.) Appointments will take place by phone instead of in-person. Please call our main number and leave a message and we will call you back within 48 hours. We appreciate your patience as call volumes are high. *This question is required.

3. If your program is sharing updates or changes on a website or social media, please enter URLs below. What you enter here will appear in a special, temporary field on your program page in the Well Badger Directory. (Optional fields)

Website
Facebook
Twitter
Others

4. If we have any follow up questions, who can we contact? (required fields) *This question is required.

Name
Title
Email
Phone