LET’S GET YOUR DEMOGRAPHICS...


“Demographics” are just general statistical information that tells something about you without actually identifying you in any way. Statisticians use demographics to help them understand more about you and how you compare to others - in your community and across the country.

TO DETERMINE YOUR COVIF-19 RISK/EXPOSURE, PLEASE PRO-VIDE THE FOLLOWING DEMOGRAPHIC DATA:

WHAT IS YOUR AGE?

WHAT IS YOUR SEX?

IN WHICH STATE DO YOU RESIDE?

IN WHICH COUNTY?

WHICH BEST DESCRIBES YOUR TYPE OF RESIDENCE?

HOW DO YOU GET TO WORK?

HOW MANY PEOPLE DO YOU WORK NEAR?

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Please enter the 4-digit refferal code: (we want to make sure it's you before we calculate)

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