diff --git a/frontend/src/components/housing/enquiry/EnquiryIntakeConfirmation.vue b/frontend/src/components/housing/enquiry/EnquiryIntakeConfirmation.vue
new file mode 100644
index 00000000..680cb5ac
--- /dev/null
+++ b/frontend/src/components/housing/enquiry/EnquiryIntakeConfirmation.vue
@@ -0,0 +1,31 @@
+<script setup lang="ts">
+import { Message } from '@/lib/primevue';
+
+import { RouteName } from '@/utils/enums/application';
+
+// Props
+type Props = {
+  assignedActivityId: string;
+};
+
+const props = withDefaults(defineProps<Props>(), {});
+</script>
+
+<template>
+  <div>
+    <h2>Confirmation of Submission</h2>
+    <Message
+      class="border-none"
+      severity="success"
+      :closable="false"
+    >
+      Your enquiry has been successfully submitted.
+    </Message>
+    <h3>Confirmation ID: {{ props.assignedActivityId }}</h3>
+    <div>
+      A Housing Navigator will review your submission and contact you. Please check your email for the confirmation
+      email and keep the confirmation ID for future reference.
+    </div>
+    <div class="mt-4"><router-link :to="{ name: RouteName.HOME }">Go to Homepage</router-link></div>
+  </div>
+</template>
diff --git a/frontend/src/components/housing/enquiry/EnquiryIntakeForm.vue b/frontend/src/components/housing/enquiry/EnquiryIntakeForm.vue
index 09555be3..85ce7498 100644
--- a/frontend/src/components/housing/enquiry/EnquiryIntakeForm.vue
+++ b/frontend/src/components/housing/enquiry/EnquiryIntakeForm.vue
@@ -7,7 +7,8 @@ import { object, string } from 'yup';
 
 import { Dropdown, InputMask, RadioList, InputText, StepperNavigation, TextArea } from '@/components/form';
 import CollectionDisclaimer from '@/components/housing/CollectionDisclaimer.vue';
-import { Button, Card, Divider, Message, useConfirm, useToast } from '@/lib/primevue';
+import EnquiryIntakeConfirmation from '@/components/housing/enquiry/EnquiryIntakeConfirmation.vue';
+import { Button, Card, Divider, useConfirm, useToast } from '@/lib/primevue';
 import { enquiryService, submissionService } from '@/services';
 import { useConfigStore } from '@/store';
 import { YES_NO_LIST } from '@/utils/constants/application';
@@ -442,22 +443,10 @@ async function emailConfirmation(activityId: string) {
       </div>
     </Form>
   </div>
-  <div v-else>
-    <h2>Confirmation of Submission</h2>
-    <Message
-      class="border-none"
-      severity="success"
-      :closable="false"
-    >
-      Your enquiry has been successfully submitted.
-    </Message>
-    <h3>Confirmation ID: {{ assignedActivityId }}</h3>
-    <div>
-      A Housing Navigator will review your submission and contact you. Please check your email for the confirmation
-      email and keep the confirmation ID for future reference.
-    </div>
-    <div class="mt-4"><router-link :to="{ name: RouteName.HOME }">Go to Homepage</router-link></div>
-  </div>
+  <EnquiryIntakeConfirmation
+    v-else
+    :assigned-activity-id="assignedActivityId"
+  />
 </template>
 
 <style scoped lang="scss">
diff --git a/frontend/src/components/housing/submission/SubmissionAssistance.vue b/frontend/src/components/housing/submission/SubmissionAssistance.vue
new file mode 100644
index 00000000..3d189d35
--- /dev/null
+++ b/frontend/src/components/housing/submission/SubmissionAssistance.vue
@@ -0,0 +1,176 @@
+<script setup lang="ts">
+import { Button, useConfirm, useToast } from '@/lib/primevue';
+import { ref } from 'vue';
+
+import { enquiryService } from '@/services';
+import { BasicResponse } from '@/utils/enums/application';
+import { IntakeFormCategory } from '@/utils/enums/housing';
+
+import type { Ref } from 'vue';
+
+// Props
+type Prop = {
+  formErrors: Record<string, string | undefined>;
+  formValues: { [key: string]: string };
+};
+
+const props = withDefaults(defineProps<Prop>(), {});
+
+// State
+const showTab: Ref<boolean> = ref(true);
+
+// Actions
+const confirm = useConfirm();
+const toast = useToast();
+
+const checkApplicantValuesValid = (
+  values: { [key: string]: string },
+  errors: Record<string, string | undefined>
+): boolean => {
+  // Check applicant section is filled
+  let applicant = values?.[IntakeFormCategory.APPLICANT];
+  if (Object.values(applicant).some((x) => !x)) {
+    return false;
+  }
+
+  // Check applicant section is valid
+  let isValid = true;
+  const errorList = Object.keys(errors);
+
+  for (const error of errorList) {
+    if (error.includes(IntakeFormCategory.APPLICANT)) {
+      isValid = false;
+      break;
+    }
+  }
+  return isValid;
+};
+
+const confirmSubmit = (data: any) => {
+  confirm.require({
+    message: 'Are you sure you wish to submit this form? Please review the form before submitting.',
+    header: 'Please confirm submission',
+    acceptLabel: 'Confirm',
+    rejectLabel: 'Cancel',
+    accept: () => onSubmit(data)
+  });
+};
+
+const emit = defineEmits(['onSubmitAssistance']);
+
+const onSubmit = async (values: any) => {
+  try {
+    const formattedData = Object.assign(
+      {
+        basic: {
+          applyForPermitConnect: BasicResponse.NO,
+          enquiryDescription: 'Assistance requested',
+          isRelated: BasicResponse.NO
+        },
+        submit: true
+      },
+      { applicant: values?.[IntakeFormCategory.APPLICANT] }
+    );
+
+    const enquiryResponse = await enquiryService.createDraft(formattedData);
+
+    if (enquiryResponse.data.activityId) {
+      toast.success('Form saved');
+      emit('onSubmitAssistance', enquiryResponse.data.activityId);
+    } else {
+      toast.error('Failed to submit enquiry');
+    }
+  } catch (e: any) {
+    toast.error('Failed to save enquiry', e);
+  }
+};
+</script>
+
+<template>
+  <Teleport to="#app">
+    <div :class="{ 'teleport-container': true, '--open': showTab }">
+      <div
+        class="assistance-tab pb-3 pt-3 pr-1 pl-1"
+        @click="showTab = !showTab"
+      >
+        <div class="tab-text">Assistance</div>
+        <font-awesome-icon
+          class="-rotate-90 mt-2"
+          icon="fa-solid fa-circle-question"
+        />
+      </div>
+      <div class="assistance-modal">
+        <div class="font-bold mb-3">Need assistance with the form?</div>
+        <div>
+          Are you unable to complete this form and need assistance? Please follow the instructions below. You will be
+          contacted by a housing navigator.
+        </div>
+        <ol class="pl-3">
+          <li class="mb-1">
+            Make sure the
+            <span class="font-bold">'Primary Contact'</span>
+            section under
+            <span class="font-bold">'Contact Information'</span>
+            tab is filled out.
+          </li>
+          <li class="mb-1">Try to fill out the form as much as you can.</li>
+          <li class="mb-1">Click "Get assistance" below to submit the form.</li>
+        </ol>
+        <div class="flex justify-content-center">
+          <Button
+            label="Get assistance"
+            :disabled="!checkApplicantValuesValid(props.formValues, props.formErrors)"
+            @click="() => confirmSubmit(props.formValues)"
+          />
+        </div>
+      </div>
+    </div>
+  </Teleport>
+</template>
+
+<style scoped lang="scss">
+.teleport-container {
+  position: fixed;
+  right: 0%;
+  bottom: 0%;
+  z-index: 5;
+  translate: 0rem;
+  transition: all 0.75s ease-in;
+
+  &.--open {
+    translate: 20rem;
+    transition: all 0.75s ease-out;
+  }
+}
+
+.assistance-modal {
+  overflow: hidden;
+  position: relative;
+  bottom: 0rem;
+  right: 0rem;
+  padding: 1rem;
+  background-color: white;
+  border-style: solid;
+  border-color: #fdb913;
+  border-width: 3px;
+  width: 20rem;
+}
+
+.assistance-tab {
+  cursor: pointer;
+  position: absolute;
+  top: 0rem;
+  transform: translate(-100%, 0%);
+  writing-mode: vertical-lr;
+  background-color: #fdb913;
+  border-top-left-radius: 0.5rem;
+  border-bottom-left-radius: 0.5rem;
+  z-index: 10;
+  color: white;
+  display: flex;
+
+  .tab-text {
+    transform: rotate(180deg);
+  }
+}
+</style>
diff --git a/frontend/src/components/housing/submission/SubmissionIntakeConfirmation.vue b/frontend/src/components/housing/submission/SubmissionIntakeConfirmation.vue
new file mode 100644
index 00000000..6b47de20
--- /dev/null
+++ b/frontend/src/components/housing/submission/SubmissionIntakeConfirmation.vue
@@ -0,0 +1,31 @@
+<script setup lang="ts">
+import { Message } from '@/lib/primevue';
+
+import { RouteName } from '@/utils/enums/application';
+
+// Props
+type Props = {
+  assignedActivityId: string;
+};
+
+const props = withDefaults(defineProps<Props>(), {});
+</script>
+
+<template>
+  <div>
+    <h2>Confirmation of Submission</h2>
+    <Message
+      class="border-none"
+      severity="success"
+      :closable="false"
+    >
+      Your application has been successfully submitted.
+    </Message>
+    <h3>Confirmation ID: {{ props.assignedActivityId }}</h3>
+    <div>
+      Your submission will be reviewed by a Housing Navigator. You may be contacted if needed. Please check your email
+      for the confirmation email and keep the confirmation ID for future reference.
+    </div>
+    <div class="mt-4"><router-link :to="{ name: RouteName.HOME }">Go to Homepage</router-link></div>
+  </div>
+</template>
diff --git a/frontend/src/components/housing/submission/SubmissionIntakeForm.vue b/frontend/src/components/housing/submission/SubmissionIntakeForm.vue
index 5a7edab4..1af75a8c 100644
--- a/frontend/src/components/housing/submission/SubmissionIntakeForm.vue
+++ b/frontend/src/components/housing/submission/SubmissionIntakeForm.vue
@@ -21,6 +21,9 @@ import {
   TextArea
 } from '@/components/form';
 import CollectionDisclaimer from '@/components/housing/CollectionDisclaimer.vue';
+import EnquiryIntakeConfirmation from '@/components/housing/enquiry/EnquiryIntakeConfirmation.vue';
+import SubmissionAssistance from '@/components/housing/submission/SubmissionAssistance.vue';
+import SubmissionIntakeConfirmation from '@/components/housing/submission/SubmissionIntakeConfirmation.vue';
 import { submissionIntakeSchema } from '@/components/housing/submission/SubmissionIntakeSchema';
 import {
   Accordion,
@@ -83,6 +86,7 @@ const { getConfig } = storeToRefs(useConfigStore());
 const activeStep: Ref<number> = ref(0);
 const addressGeocoderOptions: Ref<Array<any>> = ref([]);
 const assignedActivityId: Ref<string | undefined> = ref(undefined);
+const assistanceAssignedActivityId: Ref<string | undefined> = ref(undefined);
 const editable: Ref<boolean> = ref(true);
 const formRef: Ref<InstanceType<typeof Form> | null> = ref(null);
 const geomarkAccordionIndex: Ref<number | undefined> = ref(undefined);
@@ -241,6 +245,10 @@ async function onSubmit(data: any) {
   }
 }
 
+async function onSubmitAssistance(activityId: string) {
+  assistanceAssignedActivityId.value = activityId;
+}
+
 async function emailConfirmation(activityId: string) {
   const configCC = getConfig.value.ches?.submission?.cc;
   const body = confirmationTemplate({
@@ -344,7 +352,7 @@ onBeforeMount(async () => {
 </script>
 
 <template>
-  <div v-if="!assignedActivityId">
+  <div v-if="!assignedActivityId && !assistanceAssignedActivityId">
     <BackButton
       :confirm-leave="true"
       confirm-message="Are you sure you want to leave this page?
@@ -356,7 +364,7 @@ onBeforeMount(async () => {
     <Form
       v-if="initialFormValues"
       id="form"
-      v-slot="{ setFieldValue, values }"
+      v-slot="{ setFieldValue, errors, values }"
       ref="formRef"
       :initial-values="initialFormValues"
       :validation-schema="submissionIntakeSchema"
@@ -364,6 +372,12 @@ onBeforeMount(async () => {
       @submit="confirmSubmit"
       @change="formUpdated = true"
     >
+      <SubmissionAssistance
+        :form-errors="errors"
+        :form-values="values"
+        @on-submit-assistance="onSubmitAssistance"
+      />
+
       <input
         type="hidden"
         name="submissionId"
@@ -1504,22 +1518,14 @@ onBeforeMount(async () => {
       </div>
     </Form>
   </div>
-  <div v-else>
-    <h2>Confirmation of Submission</h2>
-    <Message
-      class="border-none"
-      severity="success"
-      :closable="false"
-    >
-      Your application has been successfully submitted.
-    </Message>
-    <h3>Confirmation ID: {{ assignedActivityId }}</h3>
-    <div>
-      Your submission will be reviewed by a Housing Navigator. You may be contacted if needed. Please check your email
-      for the confirmation email and keep the confirmation ID for future reference.
-    </div>
-    <div class="mt-4"><router-link :to="{ name: RouteName.HOME }">Go to Homepage</router-link></div>
-  </div>
+  <SubmissionIntakeConfirmation
+    v-else-if="assignedActivityId"
+    :assigned-activity-id="assignedActivityId"
+  />
+  <EnquiryIntakeConfirmation
+    v-else-if="assistanceAssignedActivityId"
+    :assigned-activity-id="assistanceAssignedActivityId"
+  />
 </template>
 
 <style scoped lang="scss">
diff --git a/frontend/tests/unit/components/shasIntake/SubmissionIntakeForm.spec.ts b/frontend/tests/unit/components/shasIntake/SubmissionIntakeForm.spec.ts
index 170bf9b3..434713ce 100644
--- a/frontend/tests/unit/components/shasIntake/SubmissionIntakeForm.spec.ts
+++ b/frontend/tests/unit/components/shasIntake/SubmissionIntakeForm.spec.ts
@@ -89,7 +89,8 @@ const wrapperSettings = () => ({
     stubs: {
       RouterLink: RouterLinkStub,
       'font-awesome-icon': true,
-      Map: true
+      Map: true,
+      SubmissionAssistance: true
     },
     directives: {
       Tooltip: Tooltip