Exit Covid-19 Survey Question Title * 1. What is your race or ethnicity? Asian Black or African American Hispanic or Latino Middle Eastern or North African Multiracial or Multiethnic Native American or Alaska Native Native Hawaiian or other Pacific Islander White Another race or ethnicity, please describe below Self-describe below: Question Title * 2. What is your age? 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 or older Prefer not to answer. Question Title * 3. How concerned are you about COVID-19? A great deal A lot A moderate amount A little None at all Question Title * 4. What methods are using to stay safe and healthy? Wearing a mask. Social distancing. Consistently cleaning surfaces. Washing or sanitizing hands. Staying home if you're sick. All of the above. None of the above. Question Title * 5. Where do you usually get COVID-19 information? Television/News Broadcast Social Media Newspaper Outlets Word of Mouth Other (please specify) Question Title * 6. How would you rate your ability to access COVID-19 resources? Excellent Fair Average Below average Far below average Other (please specify) Question Title * 7. How can we stop the spread of Covid-19 in our community? Question Title * 8. What could health experts and government officials do to continue supporting our community during COVID-19? Question Title * 9. What resources or additional information about COVID-19 would you like to know? Done
