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Flood Damage Report Form
You can use the form below to report damage to your home or property.
Flood Damage Report Form
Name
Address
City
Phone Number
Type of Property
Please Select
Home
Business
Ownership
Please Select
Own
Rent
Rental Owners Name
Was this a Primary or Secondary home?
Please Select
Primary
Secondary
Do you have Insurance?
Please Select
Yes
No
Form of Insurance (select all that apply)
Home owners
Flood
Was the insurance company notified?
Please Select
Yes
No
Date of damage
Estimated amount of damage?
Type of Damage
Please Select
Flood
Other
Flood (check all that apply)
foundation cracking
foundation bowing
water seepage
six or more inches of water in basement
furnace or water heater damaged
water on main level of home
electrical outlets damaged
Please explain.
Additional Information
Emergency Services
All Hazard Mitigation Plan
CodeRED
Emergency Management
Emergency Number Sign
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