PPE Needs and Availability for Care Workers

CareWorks of Lane County is a nonprofit project for the empowerment of people with disabilities, their families, and care workers. We value care workers, and would like to find out about their needs for personal protective equipment (PPE). Replies to this survey will be confidential, unless you specify otherwise.

For more information, please email to: careworks.of.lane.county.news@gmail.com

Or visit us at: www.solidaritynetwork.org/better-care

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* 1. First Name:

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* 2. Last Name:

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* 3. Do you live in Lane County, Oregon?

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* 4. Do you live in Eugene, Oregon?

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* 5. If outside of Lane County, OR, location (City/County/State):

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* 6. Phone Number:

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* 7. Can the above number receive text messages?

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* 8. Email:

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* 9. Click all that apply to you:

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* 10. Do you need Personal Protective Equipment (PPE)?

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* 11. If so, what types of PPE do you require for your care work or safety around care workers? Click all that apply:

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* 12. What other sorts of special support do you need? (For instance: Relief/respite, medical, social.)

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* 13. Can we add you to the CareWorks list to receive an occasional update by email?

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* 14. What public comment, if any, would you like to share, such as about being a homecare worker?

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* 15. Would you like to share the above reply publicly?

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