COVID-19 HR Questionnaire

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Business Name*
Industry Cluster*
What type of services do you provide?*
How many employees do or did you employ?*
Are your concerns related to:*
- COVID-19 re-opening
- General HR assistance
What are your greatest concerns at this time that you need assistance with?*
What’s a preferred day and time to schedule your no-cost 1-hour consultation?*
- 8am-Noon
- 1pm-5pm
- Anytime
How did you learn about the HR Hotline?*
CAPTCHA
Thank you for submitting this request. You will be contacted by our representatives within 24 business hours.

This WIOA, Title 1-financially assisted program/service is an equal opportunity employer/program. Auxiliary aids and services are available upon request to people with disabilities and/or limited English. To learn more about Equal Opportunity click here.