Caldwell County Tornado Relief Survey

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Please complete the survey below if you are a Caldwell County resident who has been personally impacted by the December 10, 2021 tornadoes. Caldwell County is reaching out to those impacted to access recovery progress, identify unmet needs, and work with partners to prevent residents from falling through the cracks. Thank you for taking the time to complete this form in its entirety, information is considered confidential and will only be shared with the Caldwell County Long Term Recovery Organization and Government partners with your consent. Please email CaldwellLTRG@gmail.com if you have any questions regarding how information will be used.

To receive additional assistance such as housing assistance from the county/state, all affected households must complete the application for FEMA assistance. County/State/Partner assistance may be available for those that receive a rejection from FEMA.

To register for FEMA visit www.DisasterAssistance.gov or call 800-621-3362

Were you a resident of Caldwell County on Dec. 10th, 2021 *

Yes

Have you applied for FEMA Assistance? *

Yes - Approved

Yes - Denied

Yes - Pending

No - Application in progress

No - Will not be applying

How was your household impacted *

No Damage

Cosmetic Damage

Minor Damage (Non-Structural, Can be lived in during repairs)

Major Damage (Structural Damage, Uninhabitable until repairs are made)

Destroyed (Home is not repairable)

Significant damage to outbuildings that have affected our livelihood / primary income

Who provided the damage assessment? *

Insurance

FEMA

Red Cross

None / Self Reported

Other:

Pre-Disaster Address (Street) *

Pre-Disaster City *

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