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COVID-19 Back to Work Game Plan Assessment Tool
This form is a Game Plan Assessment Tool that is being utilized to obtain information from businesses that would benefit from a COVID-19 Back to Work Game Plan. This is for businesses who may have been closed due to COVID-19 or those who were reduced to limited work operations, and are returning back to full operations.
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Email
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Your email
Get Back in The Game!!!
Name
*
Your answer
Email
*
Your answer
Address
*
Your answer
Phone number
Your answer
Company Name
Your answer
Nature of Your Operations
Your answer
What is your NAICS or SIC code? Type N/A if you do not know this, and we can look it up.
Your answer
How many employees are employed at your local location/facility?
Your answer
What is the square footage of your facility?
Your answer
How many shifts of employees are working or returning to work?
Your answer
Has Your Facility Been Closed since March?
Yes
No
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Do you have public/customer exposure due to the nature of your business?
Yes
No
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If so, describe....
*
Your answer
Please list departments that are at your facility, i.e., office, packaging, shipping, etc.
Your answer
Thank you for taking the time to contact K Scott Consults, LLC!
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