Covid-19 Impact Assessment

COVID-19 RESOURCE IMPACT STATEMENT

* Indicates required field

Name *

First

Last

Business Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

How many full-time employees does the business have? *

0 1-4 5-19 20-99 Other

If Other please specify: *

How has your business operations been affected by the coronavirus (COVID-19) pandemic? *

Have you experienced disruptions in your cash flow as a result of the COVID-19 crisis? *

Yes No

What other services will be beneficial to helping you grow your business? *

MBE/WBE Certfication Marketing Business Workshops

How easy is it to access information and benefits from the government COVID-19 related assistance? *

Very easy Easy Standard Difficult Very difficult

How can we improve your experience with our company? *

Would you recommend our services to a friend? *

Are you interested in receiving information regarding new resources? *

What is the best way to contact you? *

Comment *

Submit