COVID-19 Survey
We would appreciate if you could take a moment to fill out this form so that we can learn how COVID-19 and the shutdown have impacted our community so we can better serve you. Please take time to answer these questions for you and your family.
Your Name
First Name
Last Name
Your E-mail
Is CCLG your home church?
Yes
No
Are you in a Connect Group?
Yes
No
I want to be
Have you been laid off due to the impacts of Coronavirus?
Yes
No
Please share any additional details.
Have your hours been cut or has your income been reduced?
Yes
No
Other
Please share any additional details.
How many adults live in your home?
How many kids live in your home?
Has anyone in your extended family been diagnosed with COVID-19?
Yes
No
Have you been diagnosed with COVID-19?
Yes
No
Do you think you may have the virus (because testing is limited)?
Would you like a pastor or elder to reach out to you?
Yes
No
Is there anything else you would like to share with us about the impact of the virus on you or your family?
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