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Work Order For Storm Damage
This form will be kept confidential and will be used to help deploy teams quickly.
First Name
Secondary Phone
Cross Street or Landmark
Primary Language
Last Name
Email
Residence Type
Choose an option
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Check all that apply:
Over 60
Children in home
Special Needs
First Responder
Phone
Address
Structure Type
Check all that apply:
Can a team work w/o resident present
Flood Insurance
Home or Renter's Insurance
Water Status
Off
On
Power
Off
On
Is gas turned off?
Yes
No
N/A
Muck
Check all that apply:
Carpet Removal
Drywall Removal
Hardwood Floor Removal
Tile Removal
Heavy Appliance Removal
Tree Work (1"-18" wide)
Tree Work (wider than 18")
Outdoor Debris Removal Needed:
Vegetative Debris
Non-vegetative Debris
Tarping Needed:
Yes
No
Mold Remediation Needed:
Yes
No
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