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* 1. What is your age?

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* 2. What is your current gender identity? 

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* 3. What is your race?

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* 4. Were you employed prior to the COVID-19 pandemic?

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* 5. What is your occupation?

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* 6. Has your job been impacted by the spread of COVID-19, or do you expect it to be impacted?

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* 7. Have you or your family's health (physical and/or mental health) been directly affected by the COVID-19 pandemic? Please explain how.

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* 8. What Montana assistance program(s) do you (or your family) anticipate accessing or have accessed to support yourself (or your family) during the COVID-19 pandemic. Select all that apply.

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* 9. Do you have children under age 18 living in your household?

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* 10. What kind of support or other services would be most helpful to you during the pandemic?

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* 11. Did you access any of Pondera County Health Departments (PCHD) services during the pandemic? Check all that apply.

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* 12. How did you hear about the services you accessed?

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* 13. In what ways did you access educational matrials, information regarding COVID-19 and data?

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* 14. Did you find the information you gained from the resources in #13 helpful?

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* 15. Did you find the information you gained from the resources in question #13 to be clear and easy to understand?

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* 16. Rate PCHD's response efforts in the community to the COVID-19 pandemic. (1 being lowest, 5 being highest)

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* 17. We would welcome any ideas or comments to help improve our response efforts to COVID-19. 

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