Business Reboot Intake Form

Business Reboot Intake Form

Rebuild. Reimagine. Move Forward with Support.
Thank you for taking the time to complete this form. Our goal is to better understand what you need so we can get you the help you want. Whether you're rebuilding, pivoting, or starting something new, we have a large community of business professionals ready to assist.

We know forms aren’t the most exciting part of recovery — but this one should only take about 10 minutes, and it’s a big step toward getting the right support.

Please Note: After submitting this form, a member of our team will follow up with you shortly to learn more and help determine the best next steps based on your situation and available resources.

Tip: If your internet connection is unstable, please click "Save" at the bottom of the page regularly to ensure your information is saved.

[Estimated time to complete: 10 minutes]
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Before we dive in, tell us which best describes you:
- Section A: Rebooting My Existing Business
  
  Helping you get back on your feet—stronger than ever. This isn't just another form. It’s our way of getting to know your story so we can connect you to real support that fits.
- 1. Let's Start with the Basics
- What’s your business called?
- What kind of business is it?
  (e.g. bakery, auto repair, wellness coaching)
- How is your business set up?
  
  Other
- How long have you been in business?
- Tell us what you do in one or two sentences:
- Where is your business located?
- Do you rely on a physical space (like a storefront, kitchen, or workshop) to run your business??
  
  Other
- What’s the current status of your business space following the fire? (Check the option that best fits, or add your own description)
  
  Other
- Where are you currently operating from, if at all?
  (e.g., from home, a borrowed space, online only, paused for now)
- Are you planning to relocate your business, either temporarily or permanently?
- 2. How’s the Money Stuff Going?
- How is your monthly revenue now compared to 6–12 months ago?
- Do your earnings change depending on the season?
- Have your costs gone up due to recent challenges?
- Please describe how your costs have increased.
- Do you know your break-even point (how much you need to earn to cover costs)?
- Any recent cash flow gaps or late payments you're worried about?
- Are you managing loans or debt?
- 3. Customers, Community, and Competition
- Who are your typical customers?
  (e.g. families, teens, contractors, etc.)
- Have your customers changed since the fire or in the past year?
- Who else in your area offers something similar?
- How do you get the word out about your business? (Check all that apply)
- Do people find you online easily?
- 4. Team & Tools
- How many people are on your team?
- Any hiring gaps or skills you’re looking for?
- What tools/systems do you use?
  (e.g. bookkeeping software, POS systems, scheduling apps)
- Any systems or tech you’d like to upgrade or fix?
- Please describe what you’d like to upgrade or fix.
- Any supply chain or vendor challenges lately?
- Please tell us what it depends on.
- Anything else you'd like us to know?
- Section B: Starting Something New
- 1. New Business Vision
- What kind of business are you dreaming of starting?
- What inspired this idea?
- Have you already taken any first steps? (e.g. researching, registering, selling, creating products)
- Tell us more about your first steps.
- Do you have a timeline in mind for launching?
- 2. What Would Help You Most
- Where do you feel most stuck or unsure? (Check all that apply)
- Do you need help finding funding or startup capital?
- What kind of support would be most helpful?
  
  Other
- Section C: Just Exploring
  
  No pressure. You don’t need to have it all figured out yet.
- What’s on your mind?
  (e.g., I’ve been thinking about a new idea… or… I’m not sure I want to rebuild…)
- Would you like to talk with someone about your options?
- What kind of support sounds helpful to you? (Check all that apply — even if you’re not sure you’ll use it)
- Should be Empty: