Tri-Cities Mutual Aid Network Survey
***NOTE: We will keep your name private to only our resource matching volunteers.
We are Northeast Tennesseans who believe we are strongest when we cooperate and take care of one another.
The economic and health implications of the coronavirus pandemic have caused a tremendous amount of fear, anxiety, and material concerns in our every day lives. This is a national crisis. But if we can organize to be there for one another through this uncertainty, we will come out on the other side a stronger and more resilient community than ever.
We can't promise that we will be able to help you with every need you express in this survey. But we know we can't help anyone if we don't find out what our community needs are, and what resources we can pool to help. If you want to join this effort, please fill out this survey and we will be in touch.
*Obligatoire
1. Name
*
Votre réponse
2. Email
*
Votre réponse
3. City/Town
*
Votre réponse
4. Phone Number
Votre réponse
5. What immediate needs or struggles do you have right now?
Votre réponse
6. Are you willing to lend your labor/time/resources for the Tri-Cities Mutual Aid Network?
Yes
No
Not sure if I have anything to offer
Autre :
Effacer la sélection
7. Which of the following resources do you have and want to lend to the Tri-Cities Mutual Aid Network?
Extra food/gardening space
Water source
Stockpile of medications/perscriptions
Housing
Household Items
I can help provide various resources if asked and able
Autre :
8. What skills/services can you lend to the Tri-Cities Mutual Aid Network?
Cleaning
Child care
Home caretaking
Shopping and driving for older and sick people
Cooking meals
Research to identify community resources
Help increase the Tri-Cities Mutual Aid Network's resource pool
Community outreach
Car and/or home repairs
I will help with anything I am able to if asked
Autre :
9. What concerns and anxieties are you facing as a result of the coronavirus pandemic and its economic fallout?
Votre réponse
10. If you are employed, how do you feel about your employer's response to the crisis?
Votre réponse
11. In the event of lockdown, do you expect to be:
Working
In isolation
Mix of the two
Not sure
Autre :
Effacer la sélection
12. Do you fall into any of the following categories?
At-risk of severe coronavirus symptoms (older people, pre-existing conditions)
Worker facing income insecurity or unable to take paid time off
Parent
Caretaker
Small business owner
Autre :
13. Anything else you'd like to express?
Votre réponse
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