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* 1. How worried are you about the impact of coronavirus on you personally?

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* 2. At what point do you think you will feel comfortable returning to in-person worship services at Cokes Chapel?

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* 3. What precautions would you like the church to take when we return to in-person services?
(Select ALL that apply.)

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* 4. What signs/signals do you want to see before returning to in-person worship services?
(Select ALL that apply.)

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* 5. What precautions are you willing to take when you return to worship and/or other in-person gatherings?
(Select ALL that apply.)

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* 6. Are you likely to continue attending ONLINE worship after in-person services resume?

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* 7. Including yourself, what age groups are represented in your household?
(Select ALL that apply.)

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* 8. What are your expectations as to when small group, in-person gatherings should resume (i.e., Sunday School, Bible Study, Team Meetings, Youth Group, etc.)?

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* 9. What is it that you feel you need most from your church community right now?  Also, are there any additional comments or suggestions you would like to convey to the Health and Welfare Team?
(Please include your response in the box below.)

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* 10. Please type your personal information below:
(Leave name and contact information blank to submit anonymously)

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