COVID 19 Impact Survey

General Questions

Question Title

* 1. Business Type

Automotive

Construction - Commercial or Residential

Finance

Health Care

Human Resources/Staffing

Insurance

Law

Manufacturing

Marketing/Sales

Non Profit

Real Estate/Mortgage

Restaurants/Catering

Retail

Technology

Other (please specify)

Question Title

* 2. Have you had to make a reduction in your workforce due to the COVID-19 pandemic?

Yes

Question Title

* 3. What steps did your organization take in response to COVID-19 (check all that apply)

Essential Business per Governor's Executive Order

Modified Production/Services Offered

Special offers for customers/consumers

Employees working remotely

Employees Furloughed

Business has not made any changes

Business Closed

Permanently Furloughed Employees

Other (please specify)

Question Title

* 4. How many employees does your organization employ

1-5

6-10

11-20

21-50

51-99

100+

Question Title

* 5. Did you receive any funding or grants during COVID-19?

Yes

Question Title

* 6. What is the most critical issue/need your business is facing right now?

Question Title

* 7. What coalitions or business related organizations are you a member of?

Question Title

* 8. Contact Information

Name *

Company *

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address *

Phone Number