COVID-19 (Coronavirus) Business Impact Study

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* 1. Which of the following industries best represents your company?

Amusement & Entertainment

Automotive

Construction / Developers

Consumer Services

Education

Financial

Healthcare

Hotels

Insurance / Real Estate

Manufacturing

Non-Profit

Professional Services

Public Utilities

Publishers / Printers

Radio / TV

Restaurants

Retail

Transportation

Wholesalers / Distributors

Other

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* 2. Please indicate the size of your business:

Small (less than 20 employees)

Medium (20 to 49 employees)

Large (50 or more employees)

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* 3. Please indicate the Chamber(s) of Commerce to which you belong:

Terrell Chamber of Commerce

Forney Chamber of Commerce

Wills Point Chamber of Commerce

Kaufman Chamber of Commerce

Rockwall Chamber of Commerce

Canton Chamber of Commerce

Other (please specify)

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* 4. Have you lost business as a result of the COVID-19 (Coronavirus) outbreak? (please describe)

No impact

Minimal loss

Significant loss

I'm on the verge of losing my business

Comment:

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* 5. Has the outbreak impacted your operation or supply chain? (please describe)

No impact

Minimal impact

Significant impact

Comment:

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* 6. Do you anticipate any of the following impacts within the next week? (check as many as apply - please describe)

Investment in advertising

Introduction of new services for take-out/delivery services

Supply chain disruptions

Self-imposed reduction in inventory and/or output of product

Slower sales

Reduced hours of operation

Sick employees

Staff disruptions (pay/remote work/childcare needs)

Employee furloughs

Layoffs

Temporary closure of business

Business loan to bridge gap in paying employees, keeping doors open

Permanent closure of business

Other

Comment:

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* 7. Do you anticipate any of the following impacts within the next 30 days? (check as many as apply - please describe)

Investment in advertising

Introduction of new services for take-out/delivery services

Supply chain disruptions

Self-imposed reduction in inventory and/or output of product

Slower sales

Reduced hours of operation

Sick employees

Staff disruptions (pay/remote work/childcare needs)

Employee furloughs

Layoffs

Temporary closure of business

Business loan to bridge gap in paying employees, keeping doors open

Permanent closure of business

Other

Comment:

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* 8. What are your immediate needs?

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* 9. What could help your business deal with the impact of the outbreak?

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* 10. Please share your contact information with us:

First Name:

Last Name:

Company Name:

Work Phone:

Email Address: