1. Household Identification Info

(Si necesita esta encuesta en español, envíenos un correo electrónico a epha@estes.org)

The Estes Park Housing Authority is publishing this survey to gather information on how the recent COVID19 outbreak may be affecting you and your family. Please complete this survey with the best information you have, and do not hesitate to provide additional commentary at the end of the survey, or by emailing us at epha@estes.org. 

More importantly, it is the goal of Estes Park Housing Authority to work with our residents and keep everyone housed during this unprecedented and difficult time. 

If completing this survey in paper form, please return this to your respective property's drop box. If you receive this in email, please complete online.  

Please take care of yourself, your family, and your neighbors. 

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* 1. What is your name?

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* 2. At which property and unit do you reside?

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* 3. How many adults are in your household?

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* 4. How many children are in your household? (younger than 18 years)

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* 5. How many adults are/were working in your household? (if there are multiple, you will be directed to answer additional information for each working member of the household)

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