For translation assistance, please contact Kelsey.Bang-Olsen@snoco.org.
 
Help us understand how the COVID-19 pandemic is impacting you by completing this ANONYMOUS survey by January 15, 2021. Please select the best answer for each of the following questions:

Question Title

* Prior to the pandemic, how long have you been visiting a senior center?

Question Title

* In the past month, how often have you left home?

Question Title

* Which best describes who you live with?

Question Title

* Do you have a pet?

Question Title

* Do you live in Snohomish County?

Question Title

* What is your zip code?

Question Title

* Do you have a disability?

Question Title

* Please indicate which gender you identify as:

Question Title

* Please indicate which race and/or ethnicity you identify as:

Question Title

* Please indicate your age:

T