Structural Damage Assessment Form
Property Details
Property Address
Date of Assessment
Owner/Contact Name
Contact Phone
Damage Details
Type of Structure
Residential
Commercial
Industrial
Other
Construction Material
Wood
Concrete
Steel
Brick
Other
Observed Damage
Possible Cause
Extent of Damage
Minor
Moderate
Severe
Total Loss
Areas Affected
Immediate Safety Concerns
Assessor Information
Assessor Name
Assessor Signature
Additional Comments