COVID-19 Employer Impact Survey
RequiredRequired Question(s)
Required 1.
What do you consider your business' biggest need right now?
 

350 characters left.
Required 2.
What is your industry sector?
Education
Entertainment
Financial Services
Food and Beverage
Healthcare
Hotel
Petrochemical Manufacturing
Manufacturing (other)
Construction/Skilled Trades
Nonprofit
Retail
Technology
Other  
Required 3.
How many employees does your business have currently?
1-25
25-50
50-100
100-150
150-250
250-500
500+
Required 4.
What adaptations are you making to your workplace to keep your employees safe?
Additional sanitizing, hand sanitizer etc.
Rotating office shifts
Social distancing markup on floors etc.
Other  
Required 5.
Has COVID-19 resulted in...
Layoffs/furloughs
No employment changes
Increased Hiring
6.
If Layoffs is selected:
What percentage of your total headcount have you laid off?

 

50 characters left.
7.
If Furloughs is selected:
What percentage of your total headcount have you furloughed?

 

50 characters left.
Required 8.
Do you anticipate you will need to reduce your headcount in the future?
Yes
No
Other  
Required 9.
If Yes to reduce headcount is selected:
Has your company applied for these tools which can mitigate layoffs? Select all that apply

Payroll Protection Program
Layoff Aversion Funds
Economic Injury Distaster Loan
Bridge Loan
Training Funds
N/A
Required 10.
Have you experienced a decrease in your 2020 Quarter 1 (January through March) revenue, compared to your 2019 Quarter 1 revenue?

Yes
No
11.
If Yes is selected:
Can you estimate by what percentage your revenue has decreased?

 

50 characters left.
12.
What is the name and contact information for the person completing this survey?
This question is optional. We will not share identifying information publicly.


By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
City:
Postal Code:

13.
Is there anything else about your business' response to COVID-19 that you want to share? Please write in below
 

350 characters left.