Pre-Conversation Input - The Great Reset
Thank you for committing to participate in a conversation with others in your community. You are part of a larger group of people, wanting the same thing, throughout the country via The Great Reset.

The key pillars of The Great Reset are to have conversations that afford the opportunity (1) to share with humility and (2) listen with respect. There is no agenda. The intention is to empower everyone to engage in conversation.

In order for us to better understand you, and better the conversation, please answer the short 'pre-survey'. Following the group you will be asked to fill out another.

These surveys are intended to help us build better conversations and make them more compelling to people. We believe the more people talking, and the more people willing to listen leads to better and stronger communities. PLEASE BE SURE TO COMPLETE BOTH AS SOON AS THEY ARE RECEIVED.

Again, thank you for taking part in the conversation. Your participation is imperative to bring us all just a bit closer together.
Email address *
Date of upcoming conversation (if you are not participating around a table simply use the 1st day of the current month and year) *
Your location: *
Your gender: *
Your age: *
With which of the following racial or ethnic groups do you most closely identify? *
Political persuasion: *
The topic this month is 'Healthcare during Covid-19'. How comfortable do you feel talking about this topic? *
Not at all
Very comfortable
On a scale of 1-10 how do you feel the response of the United States has been to the Covid-19 spread into and throughout the country? *
Not good at all
Very good
Prior to the current situation of the Covid-19 Pandemic did you believe in the idea of Universal Healthcare (affordable and accessible healthcare for all) *
Do you feel, now, that Universal Healthcare is a good idea? *
Feel free to elaborate on the above question
Your answer
Are you following recommended social distancing? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy