Businesses Information Related to COVID-19

Businesses Information Related to COVID-19

Hello!

In an effort to collect the most accurate and up to date information, we ask that you please complete this form with information about your business related to the most current coronavirus restrictions as of 3.16.2020.

We will be sharing this information in a collected form with the public.

CORONAVIRUS BUSINESS INFORMATION

We are gathering information about businesses to share with the public about curbside/delivery, temporary closings.

Businesses During COVID-19

Name of Business*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Name:*
Email
Type of Business
- Restaurant
- Retail
- Beauty
- Service
- Non-Profit
- Gym
- Place of Worship
I am offering the following options*
- Pick Up/Carry Out
- Curbside Delivery
- Delivery
- None, closed
- Online ordering
- Online classes
- Gift certificates
- Other, please detail in next slot
Additional Information About What You Are Offering:
Website where online orders may be placed, product/program viewed
Phone Number Where Orders May Be Placed
If you are planning to close, what is the date you plan to be closed until?
MM slash DD slash YYYY
Any Other Information You'd Like the Public to Know: