Business Operation Status
1.

Company Name:

 

50 characters left.
2.

Is this a first/new report or an update.

First Report
Update (we've reported before, but things have changed
3.

Is your Business currently open?

Yes, fully open
Yes-By Appointment Only
No
Other, please explain
  • Comment:

  • 500 characters left.
4.
What are your current hours of operation?
 

350 characters left.
5.

Are you providing full business services/operations or running on a modified service/operational plan? (Please elaborate on available services/operation) We want to provide the most current information to the public.

Full Service
Curbside Pickup/Delivery Only
Online Only
Storefront open with limited services
  • Comment:

  • 500 characters left.
6.

Are there any health/safety considerations in place? Briefly explain. (ex: masks required, maximum occupancy, etc.) 

 

350 characters left.
7.
Do you have an active Website or Facebook page that outlines the level of services you are providing? By active we mean are you updating it regularly. If you do, please provide us with a link.
Yes
No
  • Comment:

  • 500 characters left.
We are working on putting together promotions for businesses as they reopen. We need your contact information below, in order to promote your business. Please complete.
 
8.
Please enter the business information indicated below. Some of the (non-personal) information could be shared publicly for promotional reasons.  

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
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code: