Cook County Illinois Business Needs Survey
RequiredRequired Question(s)
The COVID-19 outbreak has created a challenging business climate and Cook County wants to help you navigate this difficult time. Please complete the survey below to help us prioritize business assistance programs. 

Please share this survey with your network so we can collect information from as many Cook County businesses.

SIgn up for the Cook County text alerts at 888-777 with the message "alertcook"

Visit these resources for updated information: 



 
Required
Please tell us your company name. 

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
County:

What type of business is this? 

 

50 characters left.

What is the NAICS code for your business? If you do not know, you can determine here.

 

50 characters left.
Do you rent or own the property where your business is located?

Own
Rent
Please describe how has COVID-19 has negatively impacted your business:

 

350 characters left.
What are the impacts to your business? (Check all that apply) 

Access to capital to address increased costs
Business closure
Decreased customers
Employee absenteeism
Employee layoffs
Inability to respond to home-delivery requests
Inability to serve customers
Increased operating costs (e.g. employee paid leave)
Interrupted supply/delivery
Reduced hours of operation
Revenue decline
Other  
  • Comment:

  • 500 characters left.
What was your estimated annual gross revenue before COVID-19? 

At or less than $1 million annually
Between $1 million and $2 million annually
Between $2 million and $5 million annually
Greater than $5 million
What percentage revenue decline do you anticipate for 2020 as a result of COVID-19?


 

50 characters left.
What area of assistance is needed? Check all that apply and add any specific additional needs.


Business Continuity & Communication Plan
Financial & Cash Flow
Lost Business & Rapidly Declining Sales
Safety, Health, & Hygiene
Supply Chain Disruption & Delay
Workforce needs
Other  
  • Comment:

  • 500 characters left.
How many employees do you currently have?

Self-Employed
Less than 10 employees
10-24 employees
25-49 employees
50-75 employees
75-100 employees
More than 100 employees

Anything else you would like to share? Please let us know how Cook County can help you.



 

350 characters left.

Please share this survey with your network so we can collect information from Cook County businesses. Visit these resources for updated information: 


COVID-19 Response - Information for the Business Community

Chicago Cook Workforce Partnership


Thank you.