Hello,
My name is Dr. Todd Bowman and as a psychologist I am working to assess the impact of the COVID-19 for individuals, couples, and families. Please consider helping me as I work to examine the far-reaching effects that are being experienced during this unprecedented global phenomenon. Thanks in advance for your help!

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* 1. To what degree has your financial well-being been negatively
impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, workplace shutting down, furloughed, etc)?

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* 2. To what degree has your emotional well-being been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, stress and anxiety, sadness/grief, isolation, etc)?

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* 3. To what degree has your physical well-being been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, gyms and recreational facilities shutting down, etc)?

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* 4. To what degree has your spiritual well-being been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, churches and places of worship shutting down, etc)?

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* 5. To what degree has your social well-being been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, no access to restaurants, coffee shops, churches, gyms, etc)?

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* 6. To what degree has your marital/relational well-being been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, financial stress, homeschooling, etc)?

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* 7. To what degree has the well-being of your family system (relationships between all members of the family) WITHIN YOUR RESIDENCE been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, homeschooling, cabin fever, limited resources, etc)?

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* 8. To what degree has the well-being of your family system (relationships between all members of the family) OUTSIDE YOUR RESIDENCE been negatively impacted by the current COVID-19 pandemic and community solutions (ie shelter in place, minimal social contact, etc)?

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* 9. Which region of the United States do you reside in?

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* 10. Which best describes your current living environment?

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* 11. What is your biological sex?

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* 12. Please identify your race

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* 13. Please identify your ethnicity

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* 14. What is your age?

Thank you for completing this survey and contributing to our understanding of the psychosocial impact of the present circumstances. In the event that you find yourself experiencing intolerable distress in the form of negative thoughts, emotions or behaviors, please consider reaching out to a qualified therapist who can assist you in navigating the impacts of this unprecedented time in human history.

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