NAACP Boulder County Branch COVID Survey
The NAACP is collecting information about any harassment or discrimination occurring during the COVID-19 pandemic. State and local agencies are interested in knowing if anyone is experiencing such treatment, especially if it is related to wearing a face covering used to protect against transmission and contraction of the virus. No personal data is collected unless you wish to share it and potentially be contacted to follow up about your experience.
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Glenda Robinson while shopping at Home Depot, Longmont South Hover Store, was demanded to go to the end of the line.  I retorted that I only had a question.  I asked for something, he said still go to the end of the line, I'll send somebody but never did.  I worked it out by finding an employee to help me.
Age  72 *
Please provide a means of contacting you, if you would be open to follow up communications about this incident (not required)
Do you live in Boulder County? *
Race, Ethnicity, National Origin *
Do you regularly wear a protective mask or other facial protection when you leave your home or are in public *
How comfortable are you wearing a protective mask in your community based on how you feel you may be treated             5 *
If you are still visiting grocery stores, are you using facial coverings while in the store *
Are you being treated differently by people in these stores (not required)
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Are there any stores in your area that are treating people badly? Please specify the name and location (such as Bob's Burgers at 47th and Iris) (not required)
Have you experienced any microagressions since the pandemic began (please check all that apply) (not required)
Location of incident of harassment or discrimination (please be specific, such as at business _____ in Boulder at 28th and ____, or at the park at 13th and Arapahoe in Boulder) *
Date and time of incident (approximate is okay) *
Were you wearing a protective mask or other facial covering when this incident occurred *
If this incident occurred at a business, where specifically in the business did it occur (for example, at the checkout stand, or in the hardware department) (not required)
Did this incident involve harassment or discrimination by an employee? *
If it was an employee, please provide a job description or title (for example, manager, waiter, clerk) (not required)
Please describe the incident *
If you would like to, please provide a brief statement as to how the incident could have been handled differently to attain a better outcome (not required)
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