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COVID-19 Employment Survey
*
1.
Have you been furloughed or laid off due to COVID-19?
(Required.)
Yes
No
*
2.
Are you working a reduced schedule as a result of COVID-19?
(Required.)
Yes
No
*
3.
Are you receiving reduced pay as a result of COVID-19?
(Required.)
Yes
No
*
4.
Is your employer offering paid sick leave for health care providers who have contracted COVID-19?
(Required.)
Yes
No
*
5.
Have you applied for unemployment or other financial assistance?
(Required.)
Yes
No
*
6.
Do you own a clinic or business that is hurting financially as a result of the pandemic?
(Required.)
Yes
No
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