The data collected from this survey will be anonymous and used for the purpose of understanding community knowledge, attitudes, and perceptions surrounding the COVID-19 disease. We Thank you for taking the time to respond to this anonymous survey, your input will assist us in improving quality of life for residents. We appreciate all your efforts and precautions during this time. 

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* 1. I am aware that there is a CORONAVIRUS pandemic occurring

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* 2. My residence is in Will County

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* 3. My resident Zip Code is

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* 4. I am aware of the Positive COVID-19 cases in my Zip code

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* 5. My Gender is....Please select all that apply

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* 6. My Race and/or Ethnicity is...Please select all that applies 

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* 7. I am currently employed ...

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* 8. I am currently insured with Medical Benefits 

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* 9. If you do hold medical benefits, which type... please select that apply

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* 10. I receive my healthcare at the following... please select that apply

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* 11. I currently live in a... Please select all that apply

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* 12. I live with approximately... Please select that apply

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* 13. The people in my home and I are taking the following precautions during this time...Please select all that apply.

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* 14. I am aware of test sites in my area, and how to locate them...

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* 15. I plan to get the COVID-19 Vaccine, When available...

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* 16. I experience the following wellness activities....Please select all that apply

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* 17. I receive my CORONAVIRUS information from...please select that which apply

Thank you for taking our survey! For more information related to Coronavirus, please visit us @ https://willcountyhealth.org/coronavirus-information/

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