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Phoenix Business Impact Reporting Questionnaire
Welcome
If immigration enforcement activity occurred near your business and it affected your customers, sales, or employees, you can use this form to share that information with the City of Phoenix.
Sharing this information helps the City understand what local businesses are experiencing, and connect you with business support services, if you want them.
At the end of this form, you can provide your contact information if you would like a representative from the City to reach out to you. Submitting this information to the City of Phoenix is voluntary and any information you provide will be handled pursuant to the City’s data retention policy.
Tell Us About Your Business
1.
What type of business do you operate?
Restaurant or food service
Retail store
Personal services (salon, repair, childcare, etc.)
Construction or trades
Health care
Professional services (accounting, legal, consulting, insurance, real estate, design, etc.)
Manufacturing or logistics
Other (please provide details)
2.
In which Phoenix City Council District is your business located?
Find your Council District here (link)
Council District 1
Council District 2
Council District 3
Council District 4
Council District 5
Council District 6
Council District 7
Council District 8
3.
How many employees were affected at your business location?
Number of full‑time employees:
Number of part‑time employees:
About the Enforcement Activity
4.
Did you see or hear about immigration enforcement activity occurring near your business?
Yes, at my business
Yes, in an area near my business
5.
When did this happen?
(If you are unsure of the exact date, please approximate.)
Day:
Month:
Year:
Sales and Customers
6.
After the enforcement activity occurred, were your sales affected?
Yes, sales dropped more than 50%
Yes, sales dropped between 25%-50%
Yes, sales dropped less than 25%
No change in sales
Sales increased
7.
How did customer traffic change?
Significantly fewer customers
Somewhat fewer customers
No change
Somewhat more customers
Significantly more customers
8.
Anything else you want to share about customer behavior?
Workforce
9.
Did you have trouble with staffing after the enforcement activity?
Yes
No
10.
Did any employees stop coming to work or reduce their hours?
Yes
No
11.
Approximately what percentage of your workers were affected?
0%
1–10%
11–25%
26–50%
More than 50%
Business Operations
12.
Did you change your hours or close because of what happened?
Yes, reduced hours
Yes, closed temporarily
Yes, closed permanently
No
13.
Anything else you want to share about how your business operations were affected?
Business Resources
If you have questions about business resources available through the City of Phoenix, please visit
InvestInPhoenix.com (link)
Would you like to be contacted?
14.
Would you like for a representative from the City of Phoenix to contact you?
Yes, please contact me
No, I do not want to be contacted
Is there specific information or assistance you’d like to receive, such as business owner resources or help with workforce support.
15.
If you selected “Yes” please provide your contact information and a representative from the City of Phoenix will reach out to you.
Name:
Email:
Phone:
Business Name:
Business Address (Street, City, Zip):