Covid 19 Economic Impact Form
Please let us know how the current changes and restrictions are impacting your business. Answers will be forwarded directly to the Oregon Governor's office.
Business Name
Your answer
Date of form submission
MM
/
DD
/
YYYY
How is your company being affected?
Your answer
What is the estimated dollar value of the economic impact to your business as of today?
Your answer
How Many employees are affected Full time / Part Time?
Your answer
Your name and business role?
Your answer
Contact e-mail
Your answer
Contact phone
Your answer
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