Damage Assessment

A FEMA-style residential damage self-report. It helps us match repairs, supplies and funds to your ʻohana — and documents damage for assistance programs. Not for life-threatening needs (call 911).

I confirm I am reporting damage caused by the recent disaster — not pre-existing damage or maintenance issues. *

Property information

Which storm caused the damage? *

Address of damaged home *Unit / suiteIsland *Town *Structure type *Who lives in this home? *Occupancy type *Property insurance?Flood insurance? (not included in standard policies)

Other hazard insurance (all that apply)

Evaluating damage

Type / cause of damage (all that apply)

Damaged areas of home * (all that apply)

How much water entered essential living spaces? *Damage to personal belongings? *

Level of damage *

Is the damage interior, exterior or both? *Can you still get into your home? *Have you had to be out of the home? *Have you registered with the Red Cross?

What kind of services do you think you'll need? (all that apply)

How many neighbors near you also need help?Our home is NOT livable — we need shelterYour relationship to the resident

Anything else about the damage? (optional)

What do you need most right now?

Photos & contact

Photos of the damage * (required — up to 6, structural damage photos help most) Tap to add photos (required)

Your name *PhoneEmail

Your information may be shared with non-profit partners and government agencies only to coordinate emergency response and recovery for your ʻohana. This is not an application for relief programs and does not replace reporting to your insurance. For life-threatening needs call 911; for other assistance call 211.