COVID-19 Business Impact Survey

The City of Ashland Department of Community & Economic Development is conducting this survey to assess the impacts of Coronavirus (COVID-19) on local business.

Please take a few minutes to complete this survey. Your input will help us identify common challenges and deploy resources to address critical business needs.

Thank you in advance for your input. With your help, we are committed to doing our part to protect the public health and preserve and strengthen the economic health of our community.

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* 1. Contact Information

Full Name

Business Name

Business Address

Business ZIP Code

Email Address

Phone Number

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* 2. Have you experienced any impact on your business due to COVID-19?

Yes

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* 3. If yes, please describe the impact your business is experiencing.

Slower sales/no sales

Supply chain disruption

Employee absenteeism

Other (please specify)

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* 4. What steps has your business taken so far in response to COVID-19?

Open, but hours changed

Changed services (ex. take-out only)

Special offers for customers/community

Business closed

Employees teleworking

Employees furloughed or laid off (please indicate # of employees impacted)

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* 5. Please explain your answers above and share other impacts you are experiencing or creative ways you are responding.

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* 6. Are you concerned that your business may be forced to close permanently within the next few months?

Yes

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* 7. What was your annual business revenue last year?

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Between $100,000 and $150,000

Over $150,000

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* 8. Please estimate any change (or anticipated changes) in revenue your business has experienced as a result of COVID-19.

No change in revenue

Revenue Decrease of <10%

Revenue Decrease of 11%-30%

Revenue Decrease of 31%-50%

Revenue Decrease of 51%-70%

Revenue Decrease of 71%-90%

Revenue Decrease of more than 90%

Revenues have Increased

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* 9. How many employees do you have?

1-5

6-10

11-20

21-50

51-99

100+

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* 10. Which category best describes your industry/sector? Please select one.

Professional Services

Retail

Hospitality (restaurant, catering, hotels)

Construction

Manufacturing

Distribution/Warehouse/Logistics

Personal Services (salon, dry cleaner)

Non-Profit

Information Technology/Communications

Healthcare

Education or Childcare

Agriculture

Other (please specify)

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* 11. What assistance would be helpful to your business right now? (check all that apply)

Business preparedness planning/training

Information about financial assistance

Information about legal assistance

Understanding local rules and regulations for businesses

Other (please specify)

COVID-19 Business Impact Survey

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* 1. Contact Information

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* 2. Have you experienced any impact on your business due to COVID-19?

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* 3. If yes, please describe the impact your business is experiencing.

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* 4. What steps has your business taken so far in response to COVID-19?

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* 5. Please explain your answers above and share other impacts you are experiencing or creative ways you are responding.

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* 6. Are you concerned that your business may be forced to close permanently within the next few months?

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* 7. What was your annual business revenue last year?

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* 8. Please estimate any change (or anticipated changes) in revenue your business has experienced as a result of COVID-19.

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* 9. How many employees do you have?

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* 10. Which category best describes your industry/sector? Please select one.

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* 11. What assistance would be helpful to your business right now? (check all that apply)

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* 12. If you have received any financial assistance, from where have those funds come?

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* 13. Do you have business insurance?

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* 14. Does your business insurance cover loss of income?