Lee County Business Impact Survey

Question Title

* 1. Please complete your contact information below

Name

Company

Email Address

Phone Number

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* 2. What is the current operating status of your business?

Open

temporarily Closed

Re-Opened

Permanently closed

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* 3. What was the date of your reopening?

Date / Time

Date

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* 4. What is the date of closure?

Date / Time

Date

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* 5. What is your current total employee count?

Full-time

Part-time

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* 6. Has your employee count changed due to COVID 19 specifically?

Yes

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* 7. Please indicate your workforce change in each category

New Hires

Laid Off

Terminated

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* 8. What percentage of your workforce is currently working remotely?

100

Clear

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

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* 9. Have you implemented new safety measures in your facility or business?

Yes

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* 10. Please describe what safety measures you've put in place

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* 11. Has your company’s weekly revenue experienced an increase or decrease as a result of COVID-19?

Increase

Decrease

No Change

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* 12. Please estimate the percent increase

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* 13. Please estimate the percent decrease in revenue

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* 14. Have you applied for a US Small Business Administration Economic Injury Disaster Loan?

Yes

Do not qualify

I'd like more information on this program

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* 15. Have you applied for the Payroll Protection Program?

Yes

Do not qualify

I'd like more information on this program

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* 16. PPP Loan

Number of employees retained

Number of employees rehired

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* 17. Amount of PPP Loan received

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* 18. Have you had supply chain disruptions due to COVID 19?

Yes

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* 19. As the state moves toward re-opening, what challenges do you foresee for your business?

Supply chain disruptions

Employee availability

New restrictions or safety measures required

Customer demand of products/services

Decreased consumer confidence/spending

Financial impact on operations

Delayed future expansions

Other (please specify)

Lee County Business Impact Survey

Question Title

* 1. Please complete your contact information below

Question Title

* 2. What is the current operating status of your business?

Question Title

* 3. What was the date of your reopening?

Question Title

* 4. What is the date of closure?

Question Title

* 5. What is your current total employee count?

Question Title

* 6. Has your employee count changed due to COVID 19 specifically?

Question Title

* 7. Please indicate your workforce change in each category

Question Title

* 8. What percentage of your workforce is currently working remotely?

Question Title

* 9. Have you implemented new safety measures in your facility or business?

Question Title

* 10. Please describe what safety measures you've put in place

Question Title

* 11. Has your company’s weekly revenue experienced an increase or decrease as a result of COVID-19?

Question Title

* 12. Please estimate the percent increase

Question Title

* 13. Please estimate the percent decrease in revenue

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* 14. Have you applied for a US Small Business Administration Economic Injury Disaster Loan?

Question Title

* 15. Have you applied for the Payroll Protection Program?

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* 16. PPP Loan

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* 17. Amount of PPP Loan received

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* 18. Have you had supply chain disruptions due to COVID 19?

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* 19. As the state moves toward re-opening, what challenges do you foresee for your business?

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* 20. What other business supports would you think beneficial as we navigate this global challenge?

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* 21. Which one of the following best describes your organization’s primary industry? (Select one only.)