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* 1. Has the virus outbreak affected your ability to pay rent or mortgage?

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* 2. Are you struggling or unable to pay for? Please circle all that apply.

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* 3. Do you own a car or have access to one?

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* 4. Has the virus outbreak affected your current employment status?

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* 5. Can you feed yourself and your family?

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* 6. Are you able to access medical care?

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* 7. Is there someone else you are worried about?

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* 8. Do you have access to access to the Internet?

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* 9. Do you feel safe in your home?

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* 10. Are you in quarantine due to illness or caring for someone with an illness?

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* 11. I would like to stay up to date on HEZ news and updates

0 of 11 answered
 

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