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COVID-19 Employee Survey

  1. COVID-19 EMPLOYEE SURVEY

    At this point, ACCGov intends to keep operations open to maintain services for the public. However, we want to be sensitive to the needs of employees who could be more at risk or who have family or other factors that would make coming to work riskier or more difficult.

    To get a sense for those issues among our employees, we ask that you respond to the one question below.

    Please note that you should answer “yes” or “no” to the whole question without specifying the factor that applies to you.

    Simply check “yes” or “no” at the bottom of the page, complete your name and department, and submit this form.

    If you check “yes” at the bottom of the page, please complete your name and department and submit this form.

    ACCGov will keep this information confidential and use it only to make decisions about remote work or other arrangements for employees who respond “yes.”

    In light of possible community and workplace changes associated with the Coronavirus, would you be unable to come to work because of any one of the following reasons?

    - When schools or day-care centers are closed, you have need to care for a child;

    - If other services are unavailable, you would need to care for other dependents;

    - If public transport were sporadic or unavailable, you would be unable to travel to work; and/or;

    - If you or a member of your household fall into one of the categories identified by the CDC as being at high risk for serious complications from the Coronavirus, you would be advised by public health authorities not to come to work (e.g., persons with compromised immune systems; persons with underlying chronic conditions, such as heart disease, diabetes, or lung disease; or “older adults” – no cutoff age is identified in current CDC guidance)

  2. I would be unable to come to work for one or more of the reasons above

  3. Leave This Blank:

  4. This field is not part of the form submission.