Rapid Response Worker Survey 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. OK Question Title * 1. Where do you live? Philadelphia County Philadelphia Metropolitan region (5 county region) OK Question Title * 2. What industry do you work in? Food Service Retail Hotel / Hospitality Computer / IT support Construction Office / Clerical Other (please specify) OK Question Title * 3. What is your job title or main job function? OK Question Title * 4. If you are an hourly employee, what is your hourly wage? Tipped Hourly under $7.25 $7.25- $11.99 per hour $12.00 - $15.00 per hour $15.01 to $20.00 More than $20.00 per hour N/A OK Question Title * 5. If you are a salaried employee what is your annual salary? Below $23,600 $23,600 to $31,200 $31,200 to $39,000 $40,000 or more N/A OK Question Title * 6. Are you in a union or is your work covered by a collective bargaining agreement? Yes No OK Question Title * 7. Do you work as a gig worker, freelancer, independent contractor (1099) or are you self employed? Yes No OK Question Title * 8. Has your usual work activity been impacted by the COVID 19 outbreak? Yes No OK Question Title * 9. In what way has your work activity been impacted? Reduction in contracts, gigs, or scheduled hours Increase in contracts, gigs, or scheduled hours Changes to scheduled hours without a reduction in overall hours Temporary layoff with pay Temporary layoff without pay Conducting work remotely OK Question Title * 10. If you have been laid off without pay, please describe your unemployment benefits. I have already applied for unemployment benefits. I intend to apply for unemployment benefits but have not done so yet. I will not be applying for unemployment benefits. N/A OK Question Title * 11. Do you have healthcare insurance, either through your employer or the employer of your spouse? Yes No OK Question Title * 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? Yes No N/A - I do not have health insurance. OK Question Title * 13. Do you receive paid leave time from your employer (vacation, sick, etc.)? Yes No OK Question Title * 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? Yes No N/A - I do not have paid leave time available to me. OK Question Title * 15. Has your employer advanced you any paid leave that has not been earned yet? Yes No OK Question Title * 16. Do you have the ability to work remotely or telecommute for your work? Yes No OK Question Title * 17. If not, what barriers exist for this option? Remote work/Telecommuting not offered at all Remote work/Telecommuting not offered for your position Lack of access to the hardware required for this option. Lack access to the internet connection required for this option N/A OK Question Title * 18. Do you have access to / knowledge of a public computing space in your neighborhood? Yes No OK Question Title * 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. 1 2 3 4 5 6 7 8 Becoming eligible for unemployment compensation 1 2 3 4 5 6 7 8 Help filing for unemployment compensation 1 2 3 4 5 6 7 8 Help with rent / mortgage payments 1 2 3 4 5 6 7 8 Help with utilities 1 2 3 4 5 6 7 8 Help buying food / groceries 1 2 3 4 5 6 7 8 Help with childcare 1 2 3 4 5 6 7 8 Help with medical care 1 2 3 4 5 6 7 8 Help with access to health insurance OK Question Title * 20. Is there anything else you would like to share about how you have been impacted as a worker due to COVID-19? OK Question Title * 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. First Name Last Name Email address Phone number Zip code where you live OK DONE
