COVID-19 Easton Business Impact Survey
Please provide information about how the coronavirus pandemic has impacted your business operations. Your information will be kept private and all responses will help us determine what assistance is needed in Easton.
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Email *
Business Name: *
Your Name: *
Mailing Address: *
Phone Number: *
Type of Business: *
Number of Employees: *
Number of Layoffs: *
How has your business been impacted? (check all that apply) *
Required
How has your revenue changed? *
If business disruption continues, how soon will your business be at risk of closing permanently? *
How concerned are you that your business will eventually be permanently affected/closed? *
Very Little/No Concern
Extremely Concerned
Do you lease your business space? *
Have you asked your landlord for lease relief? *
Briefly explain your decision to ask or not ask for lease relief (if applicable):
Have you asked for utility payment/insurance relief? *
Briefly explain your decision to ask or not ask for utility payment/insurance relief:
What type of assistance have you applied for? (Select all that apply) *
Required
What assistance do you need from the local government?
What assistance can Discover Easton provide?
Are you offering new services or ways to do businesses that we can promote? If so, please provide details with a URL to your website or social media where this information can be found.
Other comments, questions, or concerns?
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