COVID-19 Community Needs Assessment
As our community continues to take necessary precautions to prevent the spread of COVID-19, Modus has been thinking of ways to continue serving you, your family and the rest of the Tulsa community, while keeping the health and safety of your clients and our drivers at the upmost importance. Please help us assess the current needs in the community by participating in a brief survey. The survey will take roughly 3-5 minutes. Your feedback is greatly appreciated.
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Your name *
(First & Last)
How many infants/toddlers (0-3 years old) are residing in your household? *
How many children (4-12 years old) are residing in your household? *
How many teenagers (13-19 years old) are residing in your household? *
How many young adults (20-24 years old) are residing in your household? *
How many adults (25-54 years old) are residing in your household? *
How many older adults (55 years old or older) are residing in your household? *
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