We know that voluntary, community, and social enterprise organisations  are uniquely affected by the COVID-19 pandemic. We are gathering information about the situation you are facing to enable us to make the case for additional help and to try and direct support to you. The data collected through this form will be shared by Community Action Norfolk, Voluntary Norfolk and others as part of the local response to COVID-19. You can read more about what we are doing in response to the COVID-19 pandemic, find support resources and read our privacy policy on our website http://www.communityactionnorfolk.org.uk/sites/

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* 1. What is the name of your group or organisation?

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* 2. Please include a Charity number if applicable

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* 3. Please include a Company number if applicable

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* 4. Who is completing this survey (in case we need to contact you)?

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* 5. Please tell us where your organisation works: (if you work in more than one District, please tick all that apply)

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* 6. Please tell us your organisation's postcode. If based at more than one site, please give the postcode of head office:

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* 8. Please describe your current service offer (if applicable)

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* 9. Your organisation's contact details

  Yes No
Can we include your organisation's contact details on a public list of services?
Can we share your organisation's contact details with agencies for referrals (e.g. District Councils, GPs. etc)

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* 10. Does your organisation provide any of the following (Tick all that apply)

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* 11. If you were given resources would you be able to increase your service capacity to meet COVID-19 demand?

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* 12. Are your clients/beneficiaries/residents experiencing increased needs as a result of the Covid-19 pandemic? (please provide details)

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* 13. Which of the following are issues for your organisation as a result of the COVID-19 pandemic? (tick all that apply)

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* 14. Which of the following actions have you taken as an organisation, or are very likely to take? (tick all that apply)

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* 15. It is really important to demonstrate the effect COVID-19 has had on how we support our beneficiaries. We realise some of these will be hard to answer but please try and estimate the following:

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* 17. How will your organisation cope if current circumstances continue?

  We will be in a significantly better position than we were before the pandemic We will be in a better position than we were before the pandemic We will be in the same position as we were before the pandemic We will be in a worse position than we were before the pandemic We will be at the point of failure
3 months
12 months
6 months
Now

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* 18. Tell us about your organisation's current capacity  (this is your ability to match supply with demand for your service)

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* 19. How are your current staff and volunteer levels (workforce)?

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* 20. How are your current and short term financial & other resourcing of your service?

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* 21. Tell us the financial impact the pandemic has had on your organisation

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* 22. As an organisation, do you have any support needs or other issues you would like to highlight?

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* 23. If you would like one of our team to contact you personally about your issues or support need please leave your contact details here

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* 24. If you have any other comments, questions, or concerns please tell us here:

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