COVID-19 Business Impact Survey


The following COVID-19 Business Impact Survey was developed by 25 volunteer economic development professionals who came together to meet the need for concrete information on the human and economic impacts being felt by companies in the communities we represent.

All contact information will be held in full confidentiality
Results of this survey will be shared with our economic development partners.  

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* 1. What is the current operating status of your business?

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* 2. (If Open) What percentage(%)is your current on-site operating level?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 3. (If Open) What percentage(%) is your current remote operating level?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 4. (If Open) What percentage(%) of your supplies services are you able to receive?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 5. (If Open) What percentage(%) of your goods or services are you able to ship/deliver?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 6. (If Closed) Was the decsion to close:

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* 7. (If Closed) What was the date of closure?

Date

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* 8. What is your current total employee count?

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* 9. Has your employee count changed due to COVID-19 specifically?

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* 10. (If Yes) Workforce Change

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* 11. What percentage(%) of your workforce is currently working remotely

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 12. What percentage(%) of your workforce is unable to work remotely?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 13. If employees are temporarily not reporting for work, what percentage(%) will be paid during the work hiatus?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 14. If employees are temporarily not reporting for work, what percentage(%) will not be paid during the work hiatus?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 15. If any employees are paid, approximately how many weeks will they be compensated?

1 9 18
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i We adjusted the number you entered based on the slider’s scale.

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* 16. Is your company providing any temporary aid to unpaid employees during their furlough?

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* 17. On a scale of 1-7 how would you evaluate workforce morale today?

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* 18. In addition to general health, what is your greatest concern for employees during this time of emergency? 

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* 19. Has your company's weekly revenue experienced an increase or decrease as a result of COVID-19 

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* 20. (If increased) Please estimate the percentage(%) of revenue increase?

0 50 100
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i We adjusted the number you entered based on the slider’s scale.

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* 21. (If decreased) Please estimate the percentage(%) of decrease in revenue?

0 50 100
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 22. Do you have standing lines of credit to help bridge this business interruption?

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* 23. How many weeks of a business slow down or shutdown would you estimate your business could survive before closing?

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* 24. Have you contacted your bank about a bridge loan or other financing? 

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* 25. What are your top three concerns looking forward? (Check 3 Only)

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* 26. In the next 3 months, do you anticipate any permanent reductions in your workforce?

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* 27. In the next 6 months, do you anticipate any permanent reductions in your workforce?

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* 28. Are you interested in an SBA Economic Injury Disaster Loan if or when they become available?

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* 29. What business supports would you think beneficial as we navigate this global challenge?

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* 30. Are there any thoughts, concerns, or actions you would like to share or suggest? 

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* 31. Respondent Information - All information is confidential. 
Required: City/Town & State .
SBA Assistance - Please fill entire form. 

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* 32. Name of your company's COVID-19 Customer Response Coordinator (Optional)

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* 33. Which one of the following best describes your organization's primary industry?

0 of 33 answered
 

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