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Action Inc. and local partners are trying to better understand the needs of Greater Cape Ann residents during the COVID-19 outbreak. Please take a moment to respond to this survey so that we can better help our community. Complete this survey by the end of the day Friday, May 1st and you will be entered to win a $25 Market Basket gift card if you provide your contact information.

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* 1. How often are you staying at home and practicing social distancing?

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* 2. Have you experienced any difficulties in the past 6 weeks? Please select all that apply.

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* 3. Were you working immediately prior to COVID-19?

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* 4. Are you working now?

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* 5. Are you self-employed?

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* 6. Are you concerned about paying your bills?

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* 7. Do you have internet access?

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* 8. How many days worth of food do you have in your home?

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* 9. Do you have children at home?

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* 10. What are your biggest concerns right now?

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* 11. On a scale of 1-10, how concerned are you about getting sick with COVID-19?

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* 12. What other concerns do you have?

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* 13. What town do you live in?

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* 14. Contact Information (optional)

If you provide contact information, you will have a chance to win a $25 Market Basket gift card. Your contact information will not be used for any other purposes.

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