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* 1. How many people does your business employ?

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* 2. What industry best describes your business?

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* 3. How is your organization being impacted by COVID-19? (Check all the apply.)

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* 4. Have you changed any of the following as a result of the impact of the Coronavirus outbreak on your business?

  Reduced No Change Increased
Number of staff
Hours of existing staff
Wages/salaries of existing staff

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* 5. Do you plan to make any of the following changes to your workforce in the month ahead as a result of the impact of the Coronavirus outbreak on your business?

  Reduced No change Increased
Number of staff
Hours of existing staff
Wages/salaries of existing staff

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* 6. How concerned are you about the ability to deal with each of the following over the next 30 days?

  Not at all concerned Somewhat concerned Very concerned
Maintaining adequate cash flow
Incurring excessive debt
Collecting payment from customers
Getting adequate credit from suppliers
Maintaining Solvency

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* 7. Have you taken any of the measures listed below to cover shortfalls in revenues experienced as a result of the coronavirus outbreak? Check all that apply.

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* 8. Have you applied for any of the following? Check all that apply.

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* 9. Name (optional)

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* 10. Email (optional)

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* 11. Business Name (optional)

Thank you for providing input on the impact of COVID-19 on your organization.

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