COVID 19: Potter County Impact on Businesses

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* 1. What kind of business or organization do you operate?

Accounting

Agriculture

Engineering

Entertainment

Automotive

Communications/Media

Construction

Insurance

Food Service

Fitness

Healthcare

Legal

Lodging

Manufacturing

Personal Care Services (Hair Salon)

Real Estate

Retail

Utility

Other (please specify)

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* 2. Where is your business(es) located?

Austin Area

Coudersport Area

Galeton Area

Shinglehouse Area

Roulette Area

Ulysses Area

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* 3. How has your business been affected by COVID-19? (Check all that apply)

Added expenses for cleaning supplies, gloves/masks, etc.

Change of business hours

Change of services offered

Employee lay-offs

Business closure

Employees working remotely

Loss of revenue

Disruption of supply chain

Employees with concerns about working

None of the Above

Other (please specify)

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* 4. Please provide an estimate of any lost revenue you've experienced, if applicable.

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* 5. Number of impacted employees through layoffs/adjustments in work schedules.

Self-Employed

1-5

6-10

11-20

21-30

31-40

41-50

Over 50

Comments:

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* 6. What is currently your biggest concern? (Check all that apply.)

Customers unaware that you are currently open for business

Loss of customers once pandemic is over

Employee's financial welfare

Lose of employees to another employment opportunity

Maintaining customer/employee safety

Cash flow and expenses

Inventory/Supply availability

Making payroll this pay period

Making payroll in future periods

Paying this month's rent/mortgage

Staff availability

Other (please specify)

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* 7. If business disruption continues at the current rate, is your business at risk of permanently closing?

Yes

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* 8. If at risk of permanent closure, how soon do you anticipate the closure?

Less than 1 month

1-2 months

2-3 months

3+ months

Not a concern

Other (please specify)

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* 9. What type of assistance/information would be most helpful to you right now? (Check all that apply)

Governor's/Pennsylvania's requirements for businesses

Unemployment Compensation information

Information on financial assistance over the next 90 days

Small Business Administration Disaster Loans

Other (please specify)

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* 10. If you would like to be added to an email distribution list for any updates we receive regarding COVID-19 funding and options for your business, please provide your information.

Name

Company

City/Town

Email Address