COVID-19 Business Inquiry Form

Thank you for taking time to complete this form which helps us better understand the impact of COVID-19 on your business. The information provided will also help us determine the appropriate DC agency and resources to connect you with, and further informs our economic recovery efforts. For information and resources regarding COVID-19, please visit coronavirus.dc.gov.

CONTACT INFORMATION

First Name

Last Name

Email Address

Phone Number

BUSINESS INFORMATION

Company Name

Street Address

City, State

ZIP Code

Sector

Sector (Other)

Number of Employees

BUSINESS IMPACT

Please describe how your business has been impacted by COVID-19.

What changes or challenges does your company anticipate?

What type of business resources or immediate support are you seeking?

List Business Resources or Immediate Support if "Other" selected from above field:

What is your business operating status?

If you are still open or operating modified business hours, what are your business hours?

What are your normal business hours (prior to COVID-19 disruption)?

For restaurants, please select the services you are providing:

Are you providing any free or discounted services to vulnerable residents?

Yes

INQUIRY

How may we help?

Your questions will be routed to the appropriate DC Government agency or agencies that can assist.

Would you like to be added to our distribution list to receive additional information and updates?

Yes

Send me a copy of my responses

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