The purpose of the survey is for the City of Philadelphia to better understand and respond to the needs of the region’s workers who have been impacted by COVID-19.

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* 1. Where do you live?

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* 2. What industry do you work in?

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* 3. What is your job title or main job function?

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* 4. If you are an hourly employee, what is your hourly wage?

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* 5. If you are a salaried employee what is your annual salary?

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* 6. Are you in a union or is your work covered by a collective bargaining agreement?

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* 7. Do you work as a gig worker, freelancer, independent contractor (1099) or are you self employed?

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* 8. Has your usual work activity been impacted by the COVID 19 outbreak?

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* 9. In what way has your work activity been impacted?

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* 10. If you have been laid off without pay, please describe your unemployment benefits.

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* 11. Do you have healthcare insurance, either through your employer or the employer of your spouse?

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* 12. If you have healthcare insurance from your employer or spouse, has a reduction in hours related to COVID-19 changed your access to health care benefits?

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* 13. Do you receive paid leave time from your employer (vacation, sick, etc.)?

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* 14. Have you or will you need to use paid leave due to a reduction in hours as a direct result of the COVID 19 outbreak?

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* 15. Has your employer advanced you any paid leave that has not been earned yet?

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* 16. Do you have the ability to work remotely or telecommute for your work?

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* 17. If not, what barriers exist for this option?

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* 18. Do you have access to / knowledge of a public computing space in your neighborhood?

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* 19. What types of support are needed the most? Please rank the supports below from 1 to 8, with 1 as most urgently needed and 8 as less urgently needed.

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* 20. Is there anything else you would like to share about how you have been impacted as a worker due to COVID-19?

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* 21. OPTIONAL: If you would like to be contacted with follow-up questions and additional information as it becomes available, please provide your contact information below.

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