Emergency Response Damage Assessment Individual Assistance Initial Damage Assessment
If your home has sustained damage from flood water, high wind, landslide, debris flow or any other storm-related events since January 17, we encourage you to take a moment to fill out the form below. Lane County officials will use the information provided by community members and other agencies to determine if Lane County should make a Disaster Declaration which could help open the door for federal assistance to aid in your recovery.

Please note, cost estimates for repair do not need to be 100% precise at this time. Please make every effort to provide your best guess about how much it would cost to restore your property to its pre-storm condition.
Property Owner Name  
Property Address
Street Number Street Name Street Type
 
City  
Zip Code
Phone
Estimated Property
Damage Cost
$
Cost to repair real proprerty i.e. dry out structure, replace or repair structure,
roof or driveway. Do not include personal property items or vehicles at this time.
 
 
Comments  
Property Type

 
Property is for


 
Damage Assessment



 
Insured
 
How to Prepare for an Emergency