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Individual Needs Assessment

Thank you for participating in this survey. Your responses will help the City of Evanston gauge the impact of COVID-19 upon our community. We will use the data collected to leverage state/federal resources, inform the City's budgeting and grantmaking processes, prioritize nonprofit partnerships, and support critical, social service providers in "making the case for funding." Together, with your input and voice, we will recover and rebuild.
1.In the local pandemic emergency, which services are most important to you? (check all that apply and add specific details in the comment box)(Required.)
2.How concerned are you with the following issues impacting your family/household in the coming months as a result of the COVID-19 pandemic?(Required.)
Not at all concerned
Slightly concerned
Somewhat concerned
Very concerned
N/A
Members of my household becoming infected by COVID-19
Having enough food during the pandemic
Having enough household supplies during the pandemic (cleaning supplies, toilet paper, etc.)
Helping my children with online schooling
Child care
Economic impact on my household
Access to medical services (e.g., emergency care, basic medical care and needed prescriptions)
The emotional health of my household
The safety of my community during the pandemic
Ability to pay my rent or mortgage
3.If important information about COVID-19 and our community needs to be shared, which of the following do you rely on for updates?(Required.)
4.Is there anything else you would like to share with us?
5.What is Your Age range?(Required.)
6.How would you describe your gender?(Required.)
7.What is Your Race?(Required.)
8.Are you of Hispanic, Latino, or Spanish origin?(Required.)
9.What is your approximate average household income? (Required.)
10.Which Ward Do You Reside In?(Required.)
11.Your Contact Information (optional)
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