Your Opinion Matters Please share how you have been affected by the outbreak. Question Title * 1. Personal Information (confidential) First Name * Last Name * Company Title * City State * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Zip Code * Email * Phone: Question Title * 2. Please share how you have been affected by the COVID-19 outbreak. (Check all that apply) My workload has increased My workload has decreased My responsibilities have changed I have been furloughed or laid off I have been told to work from home I still work onsite I have delayed or am considering delaying travel I am in a high-risk group or have underlying health issues I have been exposed to the virus or I am displaying signs and symptoms I have friends or family who were exposed to the virus or are displaying sign and symptoms Not impacted Question Title * 3. What has changed the most for you since the outbreak of COVID-19? Question Title * 4. What are your biggest concerns regarding the impact of COVID-19 on you and your job? Finish
