Thank you for taking time to provide feedback. We estimate this will take 5 minutes of your time.

It is more important than ever that our state government hear from Californians. This survey is an effort to give Californians the opportunity to share their experiences related to COVID-19 and its impact.

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* 1. Over the past week, how would you describe the change, if any, in your level of anxiety?

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* 2. Looking ahead to the next few weeks, how do you expect circumstances related to the pandemic in California to change?

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* 3. Rate your current level of concern for the following.

  Very Concerned Somewhat Concerned Not Sure Not Concerned Not at all Concerned
Taking public transportation
Going to work outside of my home
Getting non-COVID health care if I need it
Getting sick with COVID

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* 4. How many times have you engaged in the following activities this past week?

  0 times 1–2 times 3–4 times 5–7 times 8+ times
Gathering outdoors with people not in my immediate household
Gathering indoors with people not in my immediate household
Attending indoor worship services
Grocery shopping (in person)
Non-grocery retail shopping (in person)
Eating indoors at a restaurant
Eating outdoors at a restaurant

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* 5. How do you feel about the following activities?

  Very Risky Risky Not Sure Safe Very Safe
Eating indoors at a restaurant
Eating outdoors at a restaurant
Attending indoor worship services
Non-grocery retail shopping (in person)
Grocery shopping (in person)
Gathering outdoors with people not in my immediate household
Gathering indoors with people not in my immediate household

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* 6. How do you feel about the following travel-related activities?

  Very Risky Risky Not Sure Safe Very Safe
Traveling long distances by car, van, or RV
Staying in a short term rental (Airbnb, VRBO, etc.)
Traveling by plane
Staying in a hotel
Staying overnight with friends or family

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* 7. How do you feel about the following activities related to school starting?

  Very Risky Risky Not Sure Safe Very Safe
Sending a child to daycare
In-person, on-campus learning full time
Hybrid, combined in-person and remote learning
Remote learning full time
Organized team or club sports
Small, in-person learning pods

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* 8. Looking to the week ahead, what are you most concerned about?

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* 9. Looking to the week ahead, how worried are you about accessing food?

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* 10. Have you or any family or friends gotten sick from COVID-19?

Demographic Information

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* 11. How old are you?

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* 12. What is your zip code?

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* 13. How many people live in your home, including yourself?

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* 14. What is your current living situation?

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* 15. Which of the following best describes your current employment status?

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* 16. Which best describes your current workplace?

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* 17. As fellow Californians, we’d like to know how you’re doing. Please share with us any ideas, concerns, and etc. that you have top of mind. We read every comment.

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* 18. Please check here if you consent to allowing the State of California to anonymously use and/or quote your feedback.

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* 19. We’d like to learn more about your experience. If you’re interested in joining our research outreach list, please share your email address.

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