Small Business Needs Survey

Your input informs cost-saving opportunities for your business
and small businesses nationwide.

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Business Information

Business Name*

Organization Type*

Industry*

City

State*

Is Your Business Incorporated?

Yes No

Contact First Name

Contact Last Name

Title

Email Address

Business Website

Financial Snapshot

Revenue Range*

Monthly Expenses (Include Payroll)

Number of Employees

Monthly Expenses

Select Your Largest Monthly Business Expenses (Top 4) *

Payroll / Personnel Rent / Lease Inventory & Materials Vendors & Services Marketing & Advertising Utilities Insurance Loan Repayments Technology / Software Other

Alternatives

What Expenses Are You Open to Alternatives?

Software

Top Tools Used

Payment Processing

Payment Options Accepted (Select All That Apply) *

Square Stripe PayPal Zelle Cash App Venmo Apple Pay Google Pay Samsung Pay ACH (Bank Transfer) Wire Transfer Checks Shopify Payments QuickBooks Payments Clover Cash Credit / Debit Cards Other

Fee Perception

Fair High Too high

Banking

Satisfaction Level

Low Medium High

Capital & Loans

Do You Currently Have a Business Loan?*

Yes No

Employee Benefits

Do You Offer Life Insurance?*

Yes No

Time Demands

Most Time-Consuming Task*

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Visibility & Opportunities

* I confirm I am the owner or an authorized representative of [Business Name].* I grant permission for [Business Name's] needs and responses to be shared on the Small Business Impact Alliance website and with partners to identify opportunities that support cost savings and improve business operations.

Small Business
Impact Alliance

Small Business Impact Alliance is powered by Hasset Capital, a 501(c)(3) nonprofit organization. Membership contributions support small businesses and the network. Please consult your tax advisor regarding deductibility.

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