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Local Essential Businesses Service Questionnaire
For essential businesses offering remote ordering, curbside pickup, and/or delivery. We'll arrange your information into a Google Doc. We'll make it available for customers to see and to folks who are sharing this information on other platforms.
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* Indicates required question
Email
*
Your email
Business Name
*
Your answer
Address
*
Your answer
Type of Business
*
Please choose as many categories as fits your business. If you offer something that isn't included in this list, please click 'other' and add the category.
Groceries | Store
Farm | CSA
Home Supplies
Liquor/Wine/Beer
Farm and Garden Supplies
Medical Supplies
Sundries
Restaurants
Hardware Store
NonProfit Services
Option 11
Other:
Required
How People Can Purchase from You
*
Please choose as many as are appropriate.
Online Ordering
Phone Ordering
Curbside Pickup
Delivery
Self Serve Farmstand
Take Out
Other:
Required
Payment Methods
*
Please note: if you can, we highly suggest using credit cards, either over the phone or via a secure website, so no cash or checks need to change hands.
Credit Cards
Check
Cash
Other:
Required
Best Ways for Customers to Contact You
*
Your preferred way(s) for people to place orders.
Website
Facebook Page
Phone
Email
Other:
Website
Your answer
Facebook Page
Your answer
Phone Number
Your answer
Your Business Hours
If people need to order and/or pick up during regular business hours, please note them here.
Your answer
Ordering Requirements
Do people need to order at a specific time? In advance? In minimum quantities?
Your answer
Delivery Options
If you are offering delivery, please share if you have regular delivery schedules, specific delivery locations, delivery zones, drop-offs, etc. Also please note any delivery charges.
Your answer
Special Offerings
Is there anything in particular you want people to know that you offer?
Your answer
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