Skip to content
Survey: Your Views on COVID-19?
1.
How has the COVID-19 crisis impacted you and your family?
Severely
Moderately
Some
Not at all
Comments:
2.
If it has impacted you and your family, what are the impacts? (Select all that apply.)
Health
Job
Money / Finances
Family
Other (please specify)
3.
Are you the owner or an employee of a business impacted by the COVID-19 crisis?
Yes
No
Comments:
4.
If you are the owner or an employee of an impacted business, did the business apply for federal assistance and did it receive that assistance?
Business did not apply
Business applied but has not received
Business applied and has received but not full amount expected
Business applied and has received full amount expected
Not applicable (not an owner or employee of impacted business)
Comments:
5.
Are you eligible for unemployment benefits and have you received such benefits?
Not eligible for unemployment benefits
Eligible but have not applied or been able to apply
Eligible and applied but not received
Eligible, applied and received
Comments:
6.
Are you eligible for the federal economic impact (direct) payment and have you received payment?
Not eligible for the direct payment
Eligible but have not received
Eligible and have received
Don't know if I'm eligible
Comments:
7.
Where do you think the federal government should provide more emergency funding and other assistance? (Please select no more than three.)
Scientific research (immunizations, vaccines, better testing)
Businesses and employers
Unemployment benefits
Direct payments to citizens
State and local governments
Hospitals and health care providers
Rent, mortgage, loan and debt payments
Social services and safety net
Other (please specify)
8.
What information or assistance do you need that you are not getting now? (Select all that apply.)
COVID-19 prevention, testing and treatment
Businesses and employers
Employees, including unemployment benefits
Direct payments
Health care providers
Rent, mortgage, loan and other debt relief
Social services and safety net
Government initiatives
Other / Comments:
9.
What other questions, comments, inputs or concerns do you have on COVID-19 or any other subject?
10.
Where do you live (or which is closest to where you live)?
East Honolulu
Central Honolulu
Salt Lake - Moanalua
Aiea - Pearl City
Waipahu - Waikele - Waipio
Mililani
Ewa - Kapolei - Ko Olina
Somewhere else in Hawai'i
Not in Hawai'i
Please note that because this is anonymous I cannot reply to your comments here. If you need assistance or would like a response from me, please contact me directly
here
.
Mahalo!
