Feedback on CHW Access to COVID-19 Testing and Masks

Question Title

* 1. I identify as a

Community Health Worker (Promotore, Community Health Representative, peer, outreach worker, etc)

Ally

Unsure

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* 2. Do you hold a position of leadership in your organization?

Yes

Unsure

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* 3. What is the name of your organization?

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* 4. I work at a

Community-based organization

CHW Network (Association or Coalition)

National non-profit

College or university

FQHC

State or local public health department

Hospital or clinic

Other (please specify)

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* 5. Is your local/state health department giving you/your organization rapid at home COVID-19 tests to distribute in community?

Yes

Unsure

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* 6. Does your organization have adequate KN95 or N95 masks?

Yes

Unsure

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* 7. If you/your organization could request bulk at-home rapid COVID-19 tests, how many would you be able to distribute in a week?

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* 8. If you/your organization could request bulk KN95 or N95 masks, how many would you be able to distribute in a week?

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* 9. I am interested in working with NACHW to receive rapid COVID-19 testing kits.

Yes

Unsure

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* 10. I am interested in working with NACHW to receive KN95 or N95 masks?

Yes

Unsure

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* 11. I would be interested in receiving from NACHW

KN-95 or N95 masks

COVID-19 rapid test kits

Email communications with general updates through emails on COVID-19 rates, vaccinations, protocols, and messaging

Meetings/webinars with updates on COVID-19 rates, vaccinations, protocols, and messaging

Funding/grant opportunities related to COVID-19 response

Other (please specify)

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* 12. Location information

City/Town

State/Province

ZIP/Postal Code

Country

Feedback on CHW Access to COVID-19 Testing and Masks

Question Title

* 1. I identify as a

Question Title

* 2. Do you hold a position of leadership in your organization?

Question Title

* 3. What is the name of your organization?

Question Title

* 4. I work at a

Question Title

* 5. Is your local/state health department giving you/your organization rapid at home COVID-19 tests to distribute in community?

Question Title

* 6. Does your organization have adequate KN95 or N95 masks?

Question Title

* 7. If you/your organization could request bulk at-home rapid COVID-19 tests, how many would you be able to distribute in a week?

Question Title

* 8. If you/your organization could request bulk KN95 or N95 masks, how many would you be able to distribute in a week?

Question Title

* 9. I am interested in working with NACHW to receive rapid COVID-19 testing kits.

Question Title

* 10. I am interested in working with NACHW to receive KN95 or N95 masks?

Question Title

* 11. I would be interested in receiving from NACHW

Question Title

* 12. Location information

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* 13. Please enter your email address if you would like to join our newsletter and receive updates on our COVID-19 resources