JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Industry Critical Needs Projection
All information is voluntary and company name can be omitted if you prefer. This survey is only for items that CANNOT be procured due to supply disruptions.
Sign in to Google
to save your progress.
Learn more
Company/ Industry Name:
Your answer
County Location
Your answer
Supply/Equipment Name
Your answer
Days Remaining in Current Inventory
Your answer
Need Priority (low, medium, high)
Your answer
Where is the resource usually sourced?
Your answer
15 Day Projected Needs (what will you be needing in 15 days?)
Your answer
30 Day Projected Needs (what will you be needing in 30 days?)
Your answer
45 Day Projected Needs (what will you be needing in 45 days?)
Your answer
Mitigation Alternative(s) [Other equivalent processes or products that may be used]
Your answer
Supplies Needed to Implement Mitigation
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
