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Thank you for taking time to share information about your business to help us understand the impact of COVID-19. The information you submit will be kept confidential.

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* 1. Has the recent outbreak of COVID-19 directly impacted your organization?

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* 2. What impacts from COVID-19 is your business seeing? (Check all that apply)

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* 3. Going forward, what impacts on your business do you expect? (Check all that apply)

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* 4. If you are facing (or have already completed) layoffs, how many employees are affected? Please type in the number below for each type.

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* 5. How many employees do you typically employ? Please type in the number below for each type.

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* 6. Comparing March 2019 with March 2020 (up to today), approximately what percentage of revenue was lost as a result of COVID-19?

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* 7. Is your business offering any special discounts or promotions during this time?

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* 8. Are you starting new programs and services such as curbside pickup?

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* 9. In a few words, tell us your most immediate need.

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* 10. What assistance or resources would be helpful to your organization?

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* 11. How are you receiving information that will help inform your decisions regarding COVID-19?

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* 12. Are you a home based business or bricks and mortar?

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* 13. Contact Information

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* 14. Would you like to be added to an email list providing updates on COVID-19?

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