COVID Questionnaire
We are collecting information about how people with disabilities experienced the coronavirus pandemic in Wisconsin. Your input is helpful for us to see what happened this past year, so we can plan for the next steps.

This survey is completely anonymous. This means none of your personal information, like your name, will be saved. The data from this survey will be shared with our partners across the state to help us plan for the future.
Sign in to Google to save your progress. Learn more
Do you feel you have enough information about COVID to make good decisions for yourself?
Clear selection
Where do you get your information about COVID? Check all that apply.
What would you like to know more about regarding COVID? (You can leave this blank if you want to.)
Do you wear a mask or face covering when around other people? *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms