Business Health Survey

COVID-19

The Graham Chamber of Commerce is collecting information on the economic damage from COVID-19. The following questions are for us to have an idea of what type of assistance you will need. Help us help you, it will only take 3 minutes.
Thank you for taking the time to assist us and for staying Graham Strong!

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1. What is your primary industry/activity? w 0

Construction

Manufacturing

Retail

Wholesale

Technology

Transportation/Warehousing

Legal Services

Print/Media Publications

Finance/Insurance/Real-estate

Professional or Technical Services

Education

Hospitality or Food Establishments

Medical

Arts/Entertainment/Recreation

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2. What is your relationship with the Graham Chamber of Commerce? w 0

Happy member

Unsatisfied member

Not a member and not interested in joining

Not currently a member and interested in joining

Other (please specify)

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3. Have you had to reduce operations? w 0

50%

100%

Clear

i We adjusted the number you entered based on the slider’s scale.

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4. Have you suffered an economic injury? w 0

Yes

(please comment)

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5. Have you (or do you plan to) decrease staff capacity? w 0

Yes

(Please comment)

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6. What percentage of revenue loss has your business experienced as related to the COVID-19 pandemic? w 0

25%

50%

75%

100%

Other (please specify)

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7. How many employees have been laid off at your company as a result of COVID-19? w 0

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8. Have you changed any business practicies as a result from COVID-19? w 0

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9. Please indicate which of the following has been affected by COVID-19. w 0

Working remotely and/or employees working remotely.

Reduced hours of employees.

Absenteeism of employees to sickness.

Cancellation of business trips and/or training

Disruption is supply chain leaving you unable to receive critical supplies necessary to do business

Business impacted by fewer visitors to the area

Decrease is number of customers.

Business decline due to uncertainty and/or fears.

Other

Other (please specify)

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10. How concerned are you that your business or organization surviving this challenge? w 0

Not worried, no negative impact.

Some negative impact, but we will bounce back and be fine.

Somewhat worried about long-term impact and worried that my organization may not stay in business.

Very worried and unsure if my organization will stay in business.

We have already or are likely to go out of business.

Other (please specify)

Question Title

11. If you are interested in receiving more information regarding the CARES Act, please identify which category you are interested in below. w 0

Financial assistance for companies

Economic Support for Small Businesses

Various tax incentives

Direct payments to tax payers

Expansion of unemployment benefits

Other (please specify)

Question Title

12. Have you applied for financial assistance? w 0

	No	Yes
Economic Injury Disaster Loan (EIDL) through the Small Business Administration (SBA).	Economic Injury Disaster Loan (EIDL) through the Small Business Administration (SBA). No menu	Economic Injury Disaster Loan (EIDL) through the Small Business Administration (SBA). Yes menu
Paycheck Protection Program (PPP) through a lender.	Paycheck Protection Program (PPP) through a lender. No menu	Paycheck Protection Program (PPP) through a lender. Yes menu
Other	Other No menu	Other Yes menu

Question Title

13. OPTIONAL: please enter your contact information below if you would like to receive any follow up information as a result of this survey. w 0

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Business Health Survey

COVID-19

Question Title

* 1. What is your primary industry/activity? w 0

Question Title

* 2. What is your relationship with the Graham Chamber of Commerce? w 0

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* 3. Have you had to reduce operations? w 0

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* 4. Have you suffered an economic injury? w 0

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* 5. Have you (or do you plan to) decrease staff capacity? w 0

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* 6. What percentage of revenue loss has your business experienced as related to the COVID-19 pandemic? w 0

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* 7. How many employees have been laid off at your company as a result of COVID-19? w 0

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* 8. Have you changed any business practicies as a result from COVID-19? w 0

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* 9. Please indicate which of the following has been affected by COVID-19. w 0

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* 10. How concerned are you that your business or organization surviving this challenge? w 0

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* 11. If you are interested in receiving more information regarding the CARES Act, please identify which category you are interested in below. w 0

Question Title

* 12. Have you applied for financial assistance? w 0

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* 13. OPTIONAL: please enter your contact information below if you would like to receive any follow up information as a result of this survey. w 0

1. What is your primary industry/activity? w 0

2. What is your relationship with the Graham Chamber of Commerce? w 0

3. Have you had to reduce operations? w 0

4. Have you suffered an economic injury? w 0

5. Have you (or do you plan to) decrease staff capacity? w 0

6. What percentage of revenue loss has your business experienced as related to the COVID-19 pandemic? w 0

7. How many employees have been laid off at your company as a result of COVID-19? w 0

8. Have you changed any business practicies as a result from COVID-19? w 0

9. Please indicate which of the following has been affected by COVID-19. w 0

10. How concerned are you that your business or organization surviving this challenge? w 0

11. If you are interested in receiving more information regarding the CARES Act, please identify which category you are interested in below. w 0

12. Have you applied for financial assistance? w 0

13. OPTIONAL: please enter your contact information below if you would like to receive any follow up information as a result of this survey. w 0