Paiute Indian Tribe of Utah General Welfare Survey

To better help the Tribe determine the effect, impact, and economic loss the coronavirus has had on our tribal members and their households, we ask you to please participate in a brief survey. Responses and data collected from this survey are both anonymous confidential.

1.Please check the box if you have experienced the following impacts related to COVID-19:

Your employment has been terminated.

Your employer has decreased your income and/or work hours.

You have been laid off or furloughed.

You feel that there is a likelihood that you could lose your employment as a result of COVID-19.

You have additional family members or relatives living in your household.

You have had to support family members or relatives living outside your household.

Your medical/health expenses have increased.

Your utility expenses have increased.

Your grocery and/or food delivery expenses have increased.

You have utilized food pantry boxes/donated items.

You have had to apply for State or Tribal assistance.

You have had to make purchases related to at-home schooling.

You have had to make purchases related to remote-working, etc.

You have had to buy supplies to carry you through periods of disruption due to COVID-19.

You have had bills that you have been or will be unable to pay because of lost wages related to COVID-19?

You have seen a significant increase in your cost of living since COVID-19.

Other economic impact(s) related to COVID-19:

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