World Relief COVID-19 Neighbor Needs Assessment - English Question Title * 1. Your name: OK Question Title * 2. Your address: OK Question Title * 3. Your phone number: OK Question Title * 4. Do you need help getting these items? Check all that you need. Food Paper towels or toilet paper Water bottles Personal care items (feminine hygiene products, toothbursh, etc.) Hand sanitizer or hand soap Picking up medicine OK Question Title * 5. Do you have less hours at work or have you lost your job because of the coronavirus? Yes No OK Question Title * 6. Please list any additional needs: OK DONE