In the event of a natural disaster, it is important for property owners to complete a damage assessment form to document the extent of the damage. This information can be used to securenecessary funding and assistance from FEMA or other organizations. A damage assessment form can be completed by anyone who has knowledge of the damages, so don't hesitate to complete one even if you're not an expert! The form can be tailored to your specific needs, but generally includes information about the type of damage, its location, and photos or videos of the damage. Be sure to include as much detail as possible when completing the form. Damage assessment forms can be found online or through your local municipality. Instructions on how to complete them should also be available. Completing a damage assessment
| Question | Answer |
|---|---|
| Form Name | Damage Assessment Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | mmoderate, Summary, HAZARDS, hheavy |
DAMAGE ASSESSMENT
DATE:
TIME RECEIVED:
PERSON REPORTING:
PERSON RECEIVING:
PAGE #:
BURNING
OUT
GAS LEAK
H2O LEAK
ELECTRIC
CHEMICAL
DAMAGED*
COLLAPSED
INJURED
TRAPPED
DEAD
ACCESS
NO ACCESS
ASSIGNMENT |
COMPLETED |
TIME
LOCATION/ADDRESS
FIRES
HAZARDS
STRUCTURES
PEOPLE
ROADS
/ X
FOR USE BY EVERYONE |
10/08/01 |
Summary of all hazards in area - fill out this form on your way to Command Post and give it to Incident Command. (* for structure damage: h=heavy, m=moderate, l=light)
Incident Command: Choose an incident, put a slash in the assignment completed column, copy the address/location to the incident name section on Incident Briefing, and give Incident Briefing and Assignment Status to incident team leader. Copy address/location to