Survey: Your Current Thoughts 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 education / care
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
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 not 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.
To which, if any, of the following areas do you think the federal government should provide further 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
Other (please specify)
8.
Do you support or oppose the current 14-day quarantine on visitors or returning residents flying into Hawai'i?
Support
Oppose
Comments:
9.
Do you support or oppose a requirement that air passengers to Hawai'i be tested for COVID-19 before they are allowed to board planes?
Support
Oppose
Comments:
10.
What information or assistance on COVID-19 do you need?
11.
What other questions, comments, inputs or concerns do you have on COVID-19 or any other subject?
12.
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!