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* 1. Contact Information 

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* 2. Do you live in Assembly District 25? 

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* 3. What Short Term Impacts (within 30 days) are you, others in your community, or industry currently facing as a result of COVID-19?

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* 4. What estimated Long Term Impacts (3-6 months, 1-2 years) are you, others in your community, or industry anticipating you may face as a result of COVID-19?

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* 5. What Short Term Solutions you would like to see the state consider to address the current and/or anticipated impacts?

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* 6. What Long Term Solutions you would like to see the state consider to address the current and/or anticipated impacts?

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* 7. Do you have any additional questions? 

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* 8. Do you have any additional comments or recommendations? 

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