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Coronavirus Impact Survey – We want your feedback!
*
Indicates required field
1. How worried are you about the impact of coronavirus on you personally?
*
Extremely worried
Very worried
Somewhat worried
Not so worried
Not at all worried
2. What are the top three challenges you are currently facing?
*
General anxiety about impact of coronavirus on my life
Don’t have access to accurate information about the coronavirus
Not being connected to fellow senior center members, family and/or friends
Not being able to get enough food
I am sick or helping others who are sick
I do not have transportation to get supplies and food not to say
I am not facing any challenges
What is your household income?
*
Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
Prefer not to say
Submit
