Economic Impact Data Form

If you own or operate a hotel, resaurant, or retail store in a coastal area, you are no doubt familiar with the effects of Florida red tide on your patrons and your business.  Efforts to assess the economic impact of red tide blooms require input from local businesses.  This information is vital for decisions affecting the development and prioritization of funds necessary to monitor, control and mitigate red tide.

If you are interested in participating in this survey, please fill out the form below.

Impact Data Information
*
 denotes a required field
Outbreak Period
Start Date:
*
End Date:
Impact On Your Sales During Outbreak
Select One:
Estimated Percentage:  %
Suggestions On How We Can Help Mitigate Red Tide's
Negative Impact On Your Business
Suggestions:
Personal Information
Name:
*
Email Address:
*
e.g. yourname@yourdomain.com
Phone Number:  e.g. xxx-xxx-xxxx
Business Information
Company Name: 
Type of Business: 
Zip / Postal Code: 
 

 
 
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