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Public Form For Reporting Flood Damage
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Impact Location (The specific location where this flood impact occurred or is occurring)
*
Location Type. (What type of location was impacted?)
*
Home or Residence
Business
Garage/Shed/Dock/Outbuilding
Park
Road/Street
Damage Description (What Impacts Happened at this Location? Mark all that apply.)
Yard/Driveway Flooded
Street Flooded or Damaged
Crawlspace Flooded
Basement Flooded
First Floor or Higher Flooded
Sewer Backup
Structural Damage from Falling Tree
Structural Damage from Flooding
Degree of Impact (How severe is the impact to the location?)
*
Minimal-Able to use as normal
Minor-Access is limited; Minor flooding
Moderate-Part of the facility is not usable
Major-The facility is not usable
Destroyed-The facility has been destroyed
Insured? (What kind of insurance (if any) covers the location?)
*
No insurance
Property or Renters Insurance
Property/Renters AND Flood Insurance
Contact Information (What is the NAME/NUMBER/EMAIL of the person we can contact for more information about this impact?)
*
* indicates required fields.
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