Activate Hawaiʻi Aid ✺ COVID-19 Community Pulse Survey — 💟 Offering Help
Aloha! The goal of Community Pulse Surveys is to get a sense of who needs support, and who can kōkua (provide assistance) during this public health emergency.

▶▶▶ BEFORE YOU BEGIN, PLEASE READ THE FOLLOWING DISCLAIMER:

According to the CDC, individuals at high risk for contracting COVID-19 are adults age 60 or older and/or individuals who have underlying health conditions such as heart disease, lung disease, asthma, immunodeficiency, diabetes, and other chronic illnesses. If you answer “YES” to questions 1-6 or you answer “NO” to questions 7-9, please DO NOT volunteer for packing efforts at this time.

There are other ways you can assist including staffing the AHA Hotline (https://tinyurl.com/s6brtj6), or sewing for the Vibrant Hawai‘i mask making movement (https://www.vibranthawaii.org/volunteer). Mahalo.We also recommend making a monetary donation instead.

By completing this form, you agree to share your information with our partner agencies, including but not limited to the Hawaiʻi Island Food Basket, and others providing emergency relief and volunteer coordination.

BY PROCEEDING, YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THIS STATEMENT.
Email address *
What is your first name? *
What is your last name? *
What is your cell phone number?
Is there another number where you can be reached, such as a home phone?
What is your preferred contact method? *
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