Go

Contact Us

  • Phone: (319) 266-1264
  • Email:
  • Mailing Address: 4807 University Ave, Suite 202
    Cedar Falls, IA 50613

 

Intake Form

Initial Application
Basic Information

Love INC is not an emergency service.  We believe in taking time to hear your story and problem-solve with you.  Part of the Love INC process is the verification of information shared.  When contacted by Love INC, please be prepared to engage in the process.

Form submissions are sent over a SSL encrypted connection.

To be able to assist you, we must be able to contact you by phone.

If your phone is not reliable or if you have a secondary number we can reach you at, please provide a message number. To be able to assist you, we must be able to contact you by phone.

Where do you live? Please include street name, number, city, and zip code.

Have you ever contacted Love INC before?*

If you're a new client, how did you hear about Love INC?

Assistance Request

Please indicate what you are seeking assistance for.  There are no guarantees Love INC will be able to assist with your request(s).

Financial Request

Love INC's financial assistance is limited to $100 per year per household if approved. All financial requests require verification.

Non-Financial Request