Village of San Leanna Pandemic Response Survey

The Village of San Leanna respects your privacy. Information received through this survey will be reviewed by the City Administrator ONLY and passed along to the Mayor and Board of Aldermen in general terms without any identifying information.

Only details absolutely necessary for providing requested assistance will be shared with Village officials, staff, or volunteers, such as the request itself and details necessary for delivery or contact. 

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* 1. What are you most concerned about right now in regard to COVID-19?

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* 2. Have you been or are you likely to be displaced from your job as a result of the COVID-19 pandemic?

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* 3. What resources or skills (if any) do you hold that you would be open to sharing with other residents in the Village of San Leanna?

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* 4. Are you in a group that is considered high-risk for severe illness from COVID-19?

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* 5. Do you or anyone in your household  have physical ability, health, or transportation challenges that make it difficult to get to the grocery store or to a doctor if you become ill?

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* 6. Please provide your name, address, and contact information if you would like to share your personal concerns with the Village staff.
Please also note below if you would like Village staff to check in with you weekly regarding your health and well-being.

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