COVID-19 Economic Relief Survey Question Title * 1. Do you plan on applying for any government programs for economic relief? Yes No Unsure Question Title * 2. Have you applied for any of the following programs? (Check all that apply) Maryland Small Business COVID-19 Emergency Loan Fund Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information Maryland Small Business COVID-19 Emergency Loan Fund menu Maryland Small Business COVID-19 Emergency Relief Grant Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information Maryland Small Business COVID-19 Emergency Relief Grant menu Maryland COVID-19 Layoff Aversion Fund Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information Maryland COVID-19 Layoff Aversion Fund menu SBA Economic Injury Disaster Loan Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information SBA Economic Injury Disaster Loan menu SBA Economic Injury Disaster Advance Payment 10K Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information SBA Economic Injury Disaster Advance Payment 10K menu Federal Payroll Protection Program Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information Federal Payroll Protection Program menu Maryland COVID-19 Emergency Relief Manufacturing Fund Yes, I have applied No, I will not apply Not yet, but I plan to apply Unsure and would like more information Maryland COVID-19 Emergency Relief Manufacturing Fund menu Question Title * 3. Do you plan to apply for the Medicare Advance Payment Program? (This money must be repaid or applied against future payments.) Yes No Unsure Question Title * 4. Would you like someone from MedChi to contact you regarding any of these programs? Yes No Question Title * 5. MedChi is advocating for physicians by working to force payers, Medicare, and other government programs to help physicians in financial crisis. Do you have any suggestions you'd like to share? Question Title * 6. Please provide your contact information. Name Company City/Town Email Address Phone Number Done