Disaster Survey - 1

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Office of Housing Counseling
Survey to Assess Operational and Capacity Status of Housing Counseling Ag
Name of disaster:
Date of declaration:
State:

HCS #

Agency

HUD POC

Agency Contact

Date(s) of Date of
attempted Successsful
contact Contact

ousing Counseling Agencies after a Disaster

Facility
Facility Damaged
Agency
Operational Operational Damaged and
Staff
Operational on-site
Remotely
but open closed
impacted
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N

Are you
abke to
provide all
of your
% of staff approved
able to housing
provide counseling
services sevicess?

If not
what
services
can you
provide?

Would you
Interested in
like your
Any contact participating
delivery
Any
Any contact with FEMA,
in future loss
methods to be outreach with FEMA,
state or local mit or other
expanded to activities State or local agencies to
programs
include phone, to clients agencies for offer
related to
email, etc. Y/N Y/N
assistance Y/N assistance Y/N Recovery Y/N

If not impacted ,
are you
Have you been in able/willig to
touch with your assist clients from
parent agency for impacted
assistance or
areas/agencies?
guidaance? Y/N Y/N

If so, what
services can you
assitst with?

Notes