Seniors in Need Survey of seniors who would like help during COVID-19 Question Title * 1. Are you a senior or do you know a senior, who would benefit from help during the COVID-19 social isolation period? Yes No Question Title * 2. What activities do you need help with? Grocery and supply buying and drop off Calling to check in on needs Other (please specify) Question Title * 3. Please provide your contact information Name Address Email Address Phone Number Done
