Not in the US? Country * Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cabo Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao North Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe What is your age? *

under 18 18-24 25-29 30-39 40-49 50-59 60-64 65+

What is your gender? * Female Male Non-binary / Intersex/ Own Identity Prefer not to say

What industry do you work in? * Administration & professional services Agriculture, forestry & fishing Community & disability services Construction Education Entertainment, arts & recreation Finance, banking & insurance Health Hospitality, tourism & food services Information Technology Manufacturing Media & Communication Mining Property & other services Public services & Emergency Services Retail Trades & trades assistants Transport Utilities Warehousing & logistics Something else. None of above fit what I do

Organisation/Employer

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Employment Type *

Permanent Casual Part-time Other (please specify)

1) Are you defined as an authorised worker under the NSW Health order? *

Yes No Don’t know Other (please specify)

2) Since the lockdown have you been stood down? *

Yes, stood down entirely No Other (please specify)

3) Since the lockdown, have you had your hours reduced? *

Yes, my hours have been cut by less than 5 hours a week Yes, my hours have been cut by 5 to 8 hours a week Yes, my hours have been cut by 10 to 15 hours a week Yes, my hours have been cut by 20 hours a week or more No, my hours have remained the same. Other (please specify)

4) If you have been stood down or had your hours cut, have you received paid leave?

Yes, special paid pandemic leave applies in my workplace Yes, I have been directed by take my accrued annual leave or other accrued leave Yes, I have chosen to take my accrued leave No Not applicable Other (please specify)

5) If you have been stood down or had your hours reduced as a result of the lockdown, has your employer informed you that you are eligible to receive federal government assistance?

Yes No Not applicable Other (please specify)

6) If workers in your company have been stood down, can you give us a rough estimate of the number of workers that have been stood down? *

Yes (a box will appear to enter your number) Don’t know Not applicable

7) If you have sought access to the Covid-19 Disaster Payment, have you encountered any problems? *

Yes, a problem with my employer Yes, a problem with Services Australia No Not applicable Other (please specify)

8) If you have received assistance from Services Australia, was it an easy process? *

Very easy Fairly easy Difficult Very difficult Not applicable Other (please specify)

9) Do you know if your employer has received financial assistance from the government due to the impact of COVID-19? *

Yes, it has received assistance No, it has not received assistance No, it is not financially impacted Don’t know Other (please specify)

10) Has your employer terminated any workers in your workplace since the lockdown began? *

Yes No Don’t know Other (please specify)

11) If you answered yes to Q10, are you able to give a rough estimate of how many workers have been terminated?

12) Do you use public transport to get to work? *

Yes No Other (please specify)

13) Has your commute to work been impacted by the restrictions? *

To a great extent To some extent Not at all. Other (please specify)

14) Do you believe you have been put at risk of COVID-19 transmission in your workplace? *

To a great extent To some extent Not at all. Other (please specify)

15) Is social distancing applied in your workplace? *

Yes, at all times Yes, most of the time Yes, in indoor areas Not at all Not applicable Other (please specify)

16) Does your employer require workers to wear masks in all indoor settings, in accordance with the Public Health Order? *

Yes, it is mandatory and enforced Yes, it is encouraged, but not enforced No Not applicable Other (please specify)

17) Has your employer provided all workers with adequate PPE (personal protective equipment)? *

Yes, at the employer’s expense No, workers must provide it themselves Not applicable Other (please specify)

18) Has your employer enacted any additional measures to reduce transmission risk in your workplace? Select any that apply * Regular extra cleaning or decontamination of the workplace Changes to rosters to aid social distancing Staggered lunch breaks Other (please specify) None Not applicable

19) Would you agree that your employer’s consultation with workers around Work Health and Safety issues during this lockdown period has been good? *

Strongly agree Neither agree nor disagree Strongly disagree Other (please specify)

20) Is your employer enforcing the use of QR codes in the workplace for employees and visitors? *

Yes No Don’t know Other (please specify)

21) Has a mandatory COVID-19 testing regime been introduced in your workplace? *

Yes, for workers who live in the identified LGAs Yes, for all workers regardless of where they live No Other (please specify)

22) If you answered yes to Q21, is your employer paying workers for the testing time?

Yes No Not applicable Other (please specify)

23) Has your workplace introduced a vaccination requirement? *

Yes, it is a mandatory requirement No Other (please specify)

24) If you answered yes to Q23, has your employer introduced paid time off for workers to be vaccinated?

Yes No Not applicable Other (please specify)

Are you a member of a union? Yes No I'm retired I'm currently unemployed or unable to work 25) Do you think the NSW Government enacted the lockdown at the right time? *

No, they moved too slowly No, they moved too quickly Yes, they got the timing correct

26) Which of the follow best describes your view of economic conditions in the near future? *

The economic conditions will improve The economic conditions will worsen The economic conditions will stay roughly the same

27) Which of the following best describes your view of the outbreak and health situation in the near future? *

The health situation will improve The health situation will worsen The health situation will stay roughly the same

28) Are there any other comments you would like to share?