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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?
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
Mt. Si Senior Center | 411 Main Ave S | PO Box 806 | North Bend WA | 98045
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