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* 1. What is your home address's zip code?

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* 2. Do you have reliable access to the following? Select all that apply.

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* 3. Where do you get most of your heath information from? (Check all that apply).

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* 4. Where do you usually go to receive routine medical treatment? If more than one option, specify.

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* 5. Where does your household go for medical help in an emergency? If more than one option, specify.

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* 6. What is your household's primary healthcare coverage? Select all that apply.

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* 7. Please rate your ability to obtain healthcare services?

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* 8. What is your current level of comfort with receiving medical services?

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* 9. How often have you experienced the following over the past year?

  Not at all Several days More than half the days Nearly everyday
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Trouble concentrating on things such as reading the newspaper or watching television

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* 10. Did the COVID-19 pandemic have a significant impact on any of these behaviors?

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* 11. Has COVID-19 changed your level of health awareness?

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* 12. How has the COVID-19 pandemic made accessing healthcare services?

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* 13. Have you received any of the COVID-19 vaccines listed below?

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* 14. Do you have access to the COVID vaccine?

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* 15. Does anyone in your household suffer from any of the following? Select all that apply.

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* 16. Choose the following medical services that you are up to date on. Check all that apply.

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* 17. Select the following barriers that restrict you from receiving healthcare in your community? (Check all that apply.)

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* 18. Select the following barriers that restrict you from making healthy lifestyle choices? (Check all that apply.)

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* 19. What is your gender?

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* 20. What do you identify as? Select all that apply.

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* 21. How old are you?

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* 22. What is your current employment status? Select all that apply.

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* 23. How many family members reside in your household? (including yourself)

1 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 24. What is your annual household income?

T