COVID-19 Community Needs Assessment Survey

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* 1. What county do you live in?

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* 2. What is the current work status of all household members who were employed prior to the COVID-19 pandemic? Check all that apply.

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* 3. For any adult in the household whose workplace is still closed OR still on lay off/furlough because of COVID-19, are they expected to return to work by July 31, 2020?

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* 4. If your household had a loss of income since March 13th, what was the reason(s)? Select all that apply.

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* 5. What, if any of these actions have you taken to make sure you have enough money on hand for basic needs?

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* 6. How confident are you that your household will be able to afford the kinds of food you need for the next four weeks?

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* 7. If you did not have enough to food eat or not the kind of food you wanted to eat since COVID-19, why? Choose all that apply.

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* 8. Since COVID-19, my household accessed the following resources to meet our food/nutritional needs?

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* 9. What is your housing situation?

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* 10. HOMEOWNERS - Check all that apply

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* 11. RENTERS - Check all that apply

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* 12. How confident are you that your household will be able to pay your next rent or mortgage payment on time?

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* 13. UTILITIES - Check any and all utility bills that are past due.

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* 14. How far past due are your utilitities?

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* 15. How confident are you that your household will be able to pay all your utility bills on time next month?

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* 16. Does each member or your household that is either schooling ,working from home,  or job searching have their own computer, laptop or chrome book?

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* 17. How reliable is your household internet connection?

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* 18. What type of internet connection does your household have?

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* 19. Are there any other needs you, your families or your neighbors are experiencing?

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