COVID-19 Wellness Survey
1.
How has your income been impacted due to COVID-19?
Not at all
A little bit. Sill able to pay bills and meet needs
Some. Having to make cuts to pay bills and meet needs
A lot. Unable to pay bills and/or meet basic needs
2.
What needs related to your SCI are you having trouble finding resources for? (select all that apply)
Medical/Mobility Equipment
Medical Supplies (i.e. catheters, gloves, mask, etc.)
Attendant/Nursing Care
Medication
None. I am finding what I need
Other (please specify)
3.
How has COVID-19 impacted your social supports?
Not at all. My social support is the same
A little bit. I could use more social support, but I am good
Some. My social support is infrequent
A lot. I need someone to talk to soon
4.
What type of social support would you like to participate in?
Virtual peer support groups (via computer, phone, or tablet)
Educational webinars (via computer, phone, or tablet)
Telephone peer support groups (audio but no video)
Social media (Facebook, Twitter, Instagram, etc.)
Virtual Peer Mentoring (talking to a person with an SCI)
Other (please specify)
5.
How has your mental health been impacted during COVID-19?
Not at all. No change from before
A little bit. I may be a little bit more down or irritable
Some. I feel I could benefit from speaking to someone
A lot. I need to speak to someone now
6.
Do you know there is a COVID-19 helpline through NAMI (National Alliance on Mental Illness) you can call and talk anytime? (1-800-950-6264)
Yes
No
7.
Do you have any other comments, questions, or concerns we can assist you with?
8.
On a scale of 0 to 10,
How likely is it that you would recommend South Carolina Spinal Cord Injury Association to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
9.
If you would like one of the staff from the South Carolina Spinal Cord Injury Association to contact you, please leave your email address and/or phone number. Thank you!
10.
If you would like to receive more information from us, please leave your name, address, email (if one), and phone number.
Current Progress,
0 of 10 answered