PennLive coronavirus survey

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Please help us improve our coverage and serve our community better.

Your name?

Your e-mail address?

Do you want us to keep your information completely confidential, or may we cite your insights and experiences in our coverage?

Completely confidential

Do not identify me or my employer

You can use my insights and identify my employer, but do not identify me

You can quote me by name

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What do you want us to know about, or think about? Please share enough detail for us to fully understand your concerns.

Are there others to whom we should speak about this situation? If so, please share their names with us and tell us how we might reach them.

If there are there public records we should request in connection with your concern, please describe them.

Would you mind answering reporters' questions about this?

Glad to talk

Just wanted to leave this tip

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If you're interested in talking, what's the best number to reach you?

What is your connection to the coronavirus crisis?

I'm a doctor or nurse, treating coronavirus patients.

I'm an emergency responder -- police, fire, or EMT.

I've got coronavirus, or have had it and recovered.

I'm the friend or loved one of a coronavirus patient.

I'm quarantined or self-quarantined.

I'm someone whose job or business has been impacted by the precautions we're taking to slow the spread of coronavirus.

I'm a public health official.

I'm a researcher or academic expert.

Other:

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Where do you live?

What do you do for a living?

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