Supporting small business recovery Eastern Queensland Bushfires November 2019 - Page 1 of 2

If you are a small business owner whose business has been impacted by the bushfires, you don't have to re-build alone.

By filling out the form below, the Department of Employment, Small Business and Training will prioritise enquiries and access support from local, state and federal agencies ready to lend a hand.

Please contact us on 1300 654 687 if you'd like to talk about small business recovery.

Information provided will help us understand the impact of recent bushfires on your business and assess what support you need.

Any information you provide is confidential.

Please note: fields marked with an asterisk (*) are required.


Contact details

1. Business Name*
2. First Name*
3. Last Name*
4. Job Title
5. Email*
6. Business Phone*
7. Business Mobile

Physical business address

8. Address Line 1*
9. Address Line 2
10. Suburb*
11. Post Code*


12. Would you like someone from the Department of Employment Small Business and Training to contact you?*

13. What services are you interested in? (choose all that apply)
Rental tenancy/Landlord communications
Financial/government assistance
Business mentoring support
If other please provide details


14. ABN
15. Industry
16. Is your business part of the Tourism industry?*
17. Is your business an Indigenous business?*

Business size

18. How many people are employed in your business?*

If you don't have any employees, please enter zero (0).

19. Do you have more than 20 Full Time Equivalent employees?*

Calculating Full Time Equivalent Employees

Full time work is 35 hours per week or more. If your business has casual or part time workers, calculate the number of hours worked by these employees and divide that total by 35 to determine full time equivalents.

For example, 3 casual employees working 12 hours per week - totalling 36 hours per week, equates to one full time employee.



I authorise DESBT to provide my details to third parties to provide me with tailored information and support.

The information in this survey will assist the State Government to provide better services to the community to promote recovery from the natural disaster.

Information will be retained on the Department of Employment, Small Business and Training (DESBT) Customer Relationships Management (CRM) database so that we can contact you in the future to advise you of new issues or offers you may be interested in and to assist us to provide better services to you.

You may opt-out of any contact we initiate with you at any stage. Go to to learn more about privacy and our CRM and the Business Queensland website. We may also share your information with other Queensland Government departments to enable further services to you related to small business activities. Your information will not be disclosed for any other purpose unless you consent or it is authorised or required by law. For more privacy information go to