Wellington Region COVID-19 Disability survey

If you have had COVID in the last eight weeks, can you please complete this survey

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* 1. Have you have COVID?

Yes

No

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* 2. Did you register your result either through the link or via the telephone number?

Through the link

Via telephone

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* 3. Did you advise that you have a disability?

Yes

No

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* 4. Did you receive a phone call or communication from your GP?

Yes

No

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* 5. Did you receive a phone call or communication from the COVID response team?

Yes

No

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* 6. Did you receive any follow up calls after the initial call to check in with your well being?

Yes

No

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* 7. Did you request support?

Yes

No

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* 8. Did you receive any support if requested

Yes

No

Not applicable

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* 9. Do you still need support? (If yes, please ring 0800 829 935)

Yes

No

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* 10. Overall, have you found the process straightforward? If not, what problems did you have?

Yes

No

Comments

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* 11. If you have advised that you have a Disability, but have not been followed up by either your GP or the COVID Response Team, can you please provide your name and phone number for us to contact you.

Name

Phone Number

Thank you for completing this survey.