Covid-19 Relief Fund- Emerging Needs Survey
Agency
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your agency's "open" status? (compared to March 1 2020)
Open, no changes- business as usual
Open, changes made / precautions in place but still serving clients as usual
Physical facilities closed to the public
Staff working from home
Closed until further notice
What programs/services does your agency provide in Jennings County? Who do you serve?
What is the current impact of the COVID-19 pandemic on your CLIENTS?
What is the current impact of the COVID-19 pandemic on your AGENCY?
What are the emerging needs of your CLIENTS due to theCOVID-19 pandemic?
What are the emerging needs of your AGENCY due to theCOVID-19 pandemic?
What else do you want us to know?
Your
Name
Best phone# right now
Email
example@example.com
Submit
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