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* 1. Date / Time

Date
Time

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* 2. Contact Details:

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* 3. Type of business

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* 4. Was the business affected during the Floods?

  If yes, in what way was the business affected?
Yes
No - Skip to next question

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* 5. Did the business close during the Feb-March 2022 Floods?

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* 6. Is the business currently in operation?

  If yes, after what time period did business operations resume? If no, from today’s survey date, when do you anticipate being able to start operations again?
Yes
No

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* 7. Did your business revenue reduce during the flood event?

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* 8. If yes - as a percentage of your normal weekly turnover, how much revenue reduced during the flood event?(Use Friday 25 Feb to Friday 4 Mar)

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* 9. When did business revenue come back to its pre-disaster level?

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* 10. Was the building structure damaged by the disaster?

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* 11. Were other assets damaged by the disaster?(Plant & equipment)

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* 12. Was any stock, raw materials or finished goods destroyed or damaged by the disaster?

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* 13. Were your customers affected by your business situation?

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* 14. Are you now experiencing getting your goods/services to market?

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* 15. Have your suppliers been affected?

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* 16. Has your access to finance been affected?

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* 17. Have you experienced any delays in re-establishing lost business services after the flood event? (Electricity/Phone/Internet)

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* 18. What actions could state and local government take to help your business get back on its feet quicker?
- Give a maximum of three (3) suggestions

T