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PEOPLE'S HEALTH - COMMUNITY SURVEY
Please tell us how you feel about COVID-19. Thank you.
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Email
*
Your answer
Please enter your Zip code.
*
Your answer
What issues are affecting you during the pandemic?
*
Access to Food & Groceries
Access to Healthcare & Medicine
Paying Rent/ Bills
Looking for Work (Unemployment)
Need Housing
Loneliness (Missing friends, family, social activity, etc.)
Safety (from violence)
Need Help with Childcare
Confused/ Need more Information about the virus
Other:
Required
What resources & support do you need that you aren't currently getting?
*
Food
Healthcare/ Access to Medicine
Housing/ Rental Assistance
Employment/ Training
Mask, Hand sanitizer, and Other Personal Protections (P.P.E)
Legal Assistance
Protection & Safety
Childcare/ Resources for Kids
Education & Information about the Virus
Other:
Required
Where do you primarily get news & information about COVID-19?
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Your answer
Who do you trust in regards to COVID-19 information and support?
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Your answer
Will you take a COVID-19 vaccine when it is available?
*
Yes
No
Not Sure
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