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COVID-19 Well-Being Survey

Tell us how COVID-19 has impacted you!

In these difficult times, you can do something important for your families, friends, neighbours, and community. The information gathered will help us understand and respond to our community's needs.

Please take 5 minutes to complete this survey by June 25, 2021.

Personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act and will be used to manage and deliver FCSS related community programs and services.  If you have questions regarding the collection, use or disclosure of this information contact the Town of Vermilion FCSS at 780.581.2413 or the County of Vermilion River at 780.846.2244.
1. How would you say your mental health and personal well-being has changed due to the COVID-19 pandemic?
2. How concerned are you about the following impacts of the COVID-19 pandemic?
Space Cell Extremely concernedVery concernedSomewhat concernedNot concerned
My own mental health
Family member's mental health
Turning to substances to cope
Family stress from confinement
Increase in disagreements and conflict in my home
Violence in my home
Accessing the essential goods and items that I need
Lack of access to services and programs
Uncertainty about the future
Loss of social connection
3. Thinking about the current situation, have you experienced any of the following? (Check all that apply)
4. In times of stress and need, who do you turn to for help and support?  Please choose your top 3.
  • * This question is required.
5. Are you aware of the mental health and personal well-being resources in your community?
6. Have you or anyone in your household lost their job or experienced job instability because of the COVID-19 pandemic? (Check all that apply)
7. Since the beginning of the COVID-19 pandemic, how has it been for you or your household to meet its financial needs?
8. My age:
9. How would you describe your gender?
10. Which of the following best describes where you live?
11. How do you find out information regarding services, programs and events? (Check all that apply)
13. If you would like to be entered for our prize draw for completing the COVID-19 Well-Being Survey, please enter your name and phone number.