North Lawndale- Community Impact Survey
As we all continue to navigate uncharted territories.
The North Lawndale Community Coordinating Council is working to ask community members and community partners what are the current and upcoming needs in the community.
Please complete this survey and provide as much information as possible.
Completing the survey, does not ensure that we will be able to fulfill all needs but we want to know what is needed so we can continue to advocate on behalf of the community as much as possible.
How are you currently being impacted by Covid-19? Please check all boxes that apply.
Lack of childcare due to school closing
Loss in wages due to job closure
Loss of transportation due to safety concerns
Mental health needs due to social isolation
If you are experiencing any needs currently due to Covid-19 and the shelter in place orders, please check all of the boxes that apply to your current needs.
Medical Assistance (Physical Health)
Medical Assistance (Mental Health)
If supplies became available, please select which option would be best for you to receive them.
Pick up (Location in North Lawndale)
Drop-off in North Lawndale
Do you think Covid-19 will impact you and your families life in the long run?
If you answered yes or other to the above question, please describe the impact you think this will have?
What industry do you currently work in?
How did you learn about this survey?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service