Screen Reader Mode Icon
  • English
  • Tiếng Việt
  • اردو
  • العربية
  • မြန်မာ
  • 中文(繁體)
  • 한국어


We are conducting a survey to better understand people’s daily lives and experiences during COVID-19 (also known as the Coronavirus). The results of the survey will inform us, our partners, and policymakers on the needs in our community. We appreciate your participation in this survey, which is expected to take about15 minutes. All responses will be kept confidential. The survey is anonymous, which means we will not collect any information that would identify who you are. You can skip any question you do not wish to answer. Your participation is voluntary. It is your choice whether to participate or not. If you choose not to participate, all the services you receive at this health center will still be the same and nothing will change.

Question Title

* How old are you?

Question Title

* Are you the parent or guardian of any child under the age of 18 living in your household?