Flood and Natural Hazard Survey Form
General Information
Full Name
Date
Address
Contact Number
Location Details
Province/State
City/Town
Event Details
Type of Hazard
Flood
Landslide
Earthquake
Storm
Other
Date of Event
Duration
Brief Description of the Event
Impact Assessment
Damage to Property
Were you evacuated?
Yes
No
Number of Injuries (if any)
Number of Fatalities (if any)
Additional Comments or Remarks