COVID-19 Community Survey
The COVID-19 pandemic has impacted everyone differently. This survey was created to help community groups understand how the pandemic has had an impact on your health, financial stability, and how you are connected to community resources. The survey will be sent to as many residents as possible in the Chippewa Valley, which includes Chippewa, Dunn, and Eau Claire county. Survey results will be shared with local community organizations and all Chippewa Valley City/County Health Departments to look at future needs.

THIS SURVEY IS NOW CLOSED!  IF YOU WISH TO SUBMIT YOUR INPUT AT THIS POINT, PLEASE CONTACT LYNN BUSKE AT CVJONAHORGANIZER@GMAIL.COM

This survey is anonymous, but you have the option at the end of the survey to provide your contact information if you wish to be contacted to provide further feedback via phone and/or you wish to receive updates on the results of the survey.
Si desea completar esta encuesta en español, haga clic aquí: https://docs.google.com/forms/d/e/1FAIpQLSf_celIs0C3VxYEifJw2gENphJXd2_wGq3YS7jh19xJsk7yeA/viewform?usp=sf_link

To complete a Hmong version online click here: https://docs.google.com/forms/d/e/1FAIpQLSchbeWv17BXb2t-GFrcb-jIc8RPuce1pl-6FERWfJx6iofdOA/viewform?usp=sf_link


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1. What city do you live in or near?
2. Do you currently have a place to sleep?
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3. Where do you live? (select all that apply)
4. Do feel safe in your current living situation?
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5. Do you have enough food to eat?  
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6. Do you have the transportation you need?
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7. Can you get the healthcare you need?
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8. Do you have internet available?
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9. Are you currently working?
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10. Was your job affected by the Safer at Home order?  
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11. My income has....
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12. Overall, how have you been doing over the weeks that community members have been asked to follow Safer at Home rules due to the COVID-19 pandemic?
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13. Have you felt sadness, fear, or hopelessness that you were unable to cope with during this time?
14. Are you connected to a faith community or similar supportive practice?
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15. What is harder/bad in your daily life since the Safer at Home order due to COVID 19?
16. What is easier/good in your daily life since the Safer at Home order due to COVID 19?
17. Where have you found positive relationships during the Safer at Home order?
18. What is one thing you could have really used that was not available? (Examples: Access to food? More help from school district in home-schooling? Neighborhood connections? Were healthcare questions answered?)
19. What is one thing you know someone else could have really used? (Examples: Grocery delivery, different media coverage, childcare, mental health tips, unemployment benefits, rent deferments?)
20. Do you feel your community responded well to COVID-19 – why or why not? What do you wish the community would have done differently?
21. Do you have any other comments or concerns to share?
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