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Survey to inform recovery
North LA Interfaith has created this survey to identify the areas most impacted by storm damage and power outages. You can help by taking the
survey below.
Please share the link with your family, friends and neighbors. The survey lives at
www.nlainterfaith.org/outagesurvey
The information collected here will not be shared outside of emergency response.
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* Indicates required question
What's your zip code?
*
Your answer
What's the electricity situation where you live?
*
The power is still out
The power was out, but it's now restored
Our home never lost power
On a scale of 1 to 5, how would you rate your current situation? (answer for yourself & household)
*
1 = we're fine
1
2
3
4
5
5 = I or someone in my family is in crisis
Does someone in your household use a medical device that needs electricity?
Yes, and I have no way to power it
Yes, but I have access to electricity
No
Clear selection
As the temperature rises over the next few days, do you have access to a place with electricity to cool off?
Yes
No
Clear selection
Do you need help finding or getting to a cooling site?
Yes
No
Clear selection
Please share your biggest concerns right now:
Your answer
First Name:
Your answer
Last Name:
Your answer
Phone Number:
Your answer
Email address:
Your answer
If you're a member of a congregation or civic organization, please share which one(s):
Your answer
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