Please note: The information gathered on this form is kept strictly confidential. Your information is only used by SBDC staff and NOT made public, shared or available to third parties.
Contact information: (Items with * are required)
Email address is required; phone number is strongly recommended
Request for counseling information*
Would you like to tell us more about yourself and/or your business?
Fill out the optional fields below to better prepare your advisor for your meeting.
Select the county you wish to receive counseling in (required):
PLEASE NOTE: If you are in New York City, the following counties correspond to the five Boroughs:
Manhattan - New York
Bronx - Bronx
Brooklyn - Kings
Queens - Queens
Staten Island - Richmond
New York State Small Business Development Center Client Disclaimer (Required)
I request management assistance from The New York State Small Business Development Center. I understand that this assistance is free of charge and that I incur no obligation to The New York SBDC or the U.S. Small Business Administration or its counselors for providing this assistance. I agree to cooperate should I be selected to participate in surveys designed to evaluate assistance services. I authorize the New York SBDC to furnish relevant information to the assigned management counselor(s) although I expect that information to be held in strict confidence to the extent allowable by law.
I further understand that any counselor has agreed not to: (1) recommend goods or services from sources in which he/she has an interest and (2) accept fees or commissions developing from this counseling relationship. In consideration of the SBDC, in cooperation with the SBA furnishing management or technical assistance, I waive all claims against The New York State SBDC, SBA, personnel or counselors arising from this assistance.