Disaster Survey - 2

SURVEYMONKEY

Office of Housing Counseling
Survey to Assess Operational and Capacity Status of Housing Counseling Agencies after a Disaster
Name of disaster:
Date of declaration:
State:

1. HCS #

2. Agency Name/Location

3. Who is your HUD Point of Contact?

4. Agency Contact

5. Initial Survey

Yes

No

6. Follow-up Survey

Yes

No

7. Is your agency operational?

Yes

No

8. Are you operational on-site or remotely?

On-site

Remotely

Not operational

9. If your facility was damaged, are you open?

Yes

No

Facility was not damaged

10. Were any of your staff impacted?

Yes

No

11. If so, approximately what percentage of staff can provide services?

100%

75%

50%

25%

0%

12. Are you able to provide all your approved housing counseling services?

Yes

No

13. If no, what services can you provide?

14. Would you like your delivery methods shown in HCS to be expanded to include phone, email, etc.?

Yes

No

15. Have you contacted FEMA, State or local agencies to request assistance for your agency?

Yes

No

Other (please specify)

16. Have you contacted FEMA, state or local agencies to offer assistance?

Yes

No

17. Have you started any outreach activities to your clients?

Yes

No

18. Are you interested in participating in future loss mitigation or other programs related to Recovery?

Yes

No

19. Have you contacted your parent agency for assistance or guidance?

Yes

No

N/A

20. If you were not impacted, are you able/willing to assist clients from impacted areas/agencies?

Yes

No

21. If so, what services can you assist with?

22. Notes (extent of damage, support from parent, types of client outreach, other problems, successes, etc.)

DONE

0 of 22 answered