To assist us with providing technical assistance and in response to requests from your peers, this questionnaire is intended to collect information on how Ombudsman programs have used (or plan to use) federal COVID-19 relief funding.

This questionnaire asks you to identify the source of federal funding for each example of how you (or your representatives) spent (or plan to spend) the funds.

Review this chart for descriptions of sources of federal COVID-19 relief funds and highlights of ACL FAQs. 
 
Please share examples of final products either by uploading a file or sharing a link in the comment box. You can fill out this questionnaire multiple times to share examples of how your program utilizes these funds. NORC will use this information to create and update a chart on the website as new examples are shared. If you have questions, please contact ombudcenter@theconsumervoice.org.

Question Title

* 1. Contact Information

Question Title

* 2. Choose primary source of funding for the examples in this response (please select one source per questionnaire response).

Question Title

* 3. Is this example replacing an example you have already shared with us or is it an additional example?

Question Title

* 4. How did you use this funding?

Question Title

* 5. Are you (or your representatives) encountering any barriers in spending the funds?

Question Title

* 6. Additional Comments

Share Examples Below

Question Title

* 7. Share a link to the finished product your program created using this funding. For example, a new brochure, a job description for a new position, postcards, new training materials, a public service announcement/commercial, program promotion materials, volunteer recruitment, etc.

Question Title

* 8. Share an additional link (optional)

Question Title

* 9. Share an additional link (optional)

Question Title

* 10. Upload a file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 11. Upload a file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 12. Upload a file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 13. Upload a file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 14. Upload a file

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

T