Donate Furniture
  • Dallas Furniture Bank is grateful to receive gently or lightly used basic household furniture items and home furnishing accessories.
Donate Money
  • DFB is sustained by the generosity of our donors. Your financial contributions greatly impact and improve the quality of life, self-esteem and chance of success for those individuals/families in need.
Donate Time
  • Dallas Furniture Bank offers many opportunities for you to volunteer your time and make a difference in the community.

Client Referral

Approved partner agencies use only.

ALL fields starred are required, otherwise it is optional.

The information recorded in this form will be maintained with strict confidentiality and will only be used by DFB staff for processing furniture requests, making contacts for outcome measures and for reporting demographical/statistical information.

Client Information








Household Information

Total Number of People in Household How many are children?

What are the ages and gender of all the children in your household age 18 and under?
Child 1: Age F
Child 2: Age F
Child 3: Age F
Child 4: Age F
Child 5: Age F
Child 6: Age F

Is head of household employed? Yes  No

Household Income (approximately): / month.
Source of Income:

Primary Language:

If other, please indicate:


Furniture Items Requested (OPTIONAL)
Indicate the # of items in each box you will need. If none are need, please enter "0".

Living Room:
Sofa  Loveseat/Chair  Coffee Table  End Table

Dining Room:
Dining/Kitchen Table  Dining/Kitchen Chairs 

Bedroom:
Baby Bed/Crib  Twin  Full  Queen  King

Bunk Beds  Dresser/Chest of Drawers  Night stand

Desk  Head/Foot Board 

Accessories:
Lamp(s)  Wall Hangings(2)  TV

Other Items:

Delivery service needed? Yes  No

All referrals that pick up furniture from DFB warehouse MUST bring: 1) Their own loading assistance and 2) their own tie-downs and protective coverings.


Demographic Information

The following information is used for demographic reporting only

What primary reason initiated your client's need for furniture? *

Loss of employment / income
Fire/Flood/Natural Disaster
Transitional / Substance Abuse
Incarceration / Re-entry to community
In Retreat / Domestic Violence
Transitional / Mental Health Issue
Transitional / Homeless (non-specific)
Other

Ethnicity: *
African-American/Black
American Indian
Anglo/White
Asian-American
Latino/Hispanic
Other

Age Range*:
17 - 20 yrs old
20 - 29 yrs old
30 - 49 yrs old
50 - 65 yrs old
65 and older

Marital Status*:
Single
Married
Divorced
Separated
Widowed

Gender*: Male  Female


Partner Agency Information




Preferred Transaction Method:
Client Self-Pay  Agency Credit Line  Invoice to Agency

(Due to DFB within 21 days from date of purchase)


Notes and Disclaimer

Please list here any specific/pertinent information regarding this referral that is relevant to DFB and its handling of this referral.

Disclaimer: All furniture items at DFB are sold "as is". These items are lightly used donated goods. The DFB will ensure that any known defect or problem with a furniture item is revealed prior to its purchase. The DFB does not offer any warranties or guarantees for any of the items purchased. Additionally, the DFB will not be responsible for items picked up by the client or member agency that are damaged during transfer.