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Case Management After Hurricane Helene
This form is designed to connect individuals and families in Watauga County who are affected by Hurricane Helene with a Disaster Case Manager. Please provide as much information as possible regarding your current situation and needs. A Disaster Case Manager will review your responses and contact you to provide information about available resources and assistance. Your information will be kept confidential and shared only with organizations directly involved in the recovery efforts following Hurricane Helene.
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* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
Are you currently living in Watauga County?
*
Yes
No
Other:
Telephone Number
*
Your answer
Email Address
Your answer
Current Address Including Zip Code
*
Your answer
Address At Time Of Hurricane Helene Including Zip Code
*
Your answer
Are You A Renter Or A Homeowner?
*
Renter
Homeowner
Other:
Number Of People In Household
Your answer
Indicate Areas Of Need Related To Hurricane Helene
Utilities (Check box if there are concerns with septic, well, spring box, water quality, electrical )
Home Repair (Check if there are damages to roof, foundation, ceiling, walls, windows, doors/entry points)
Land Issues (Check if property flooded, landslide near home, water flowing toward home or near home)
Access Issues (Check if driveway, culvert, road or bridge is damaged)
Debris Removal (Check if you have trees, home repair debris, household/furniture items that need removing)
Temporary Housing (Check if you are getting home repair or replacement and need help with temporary housing)
Storage (Check if you need help acquiring storage for household furniture and belongings while getting home repair/replacement)
Furniture & Household Items (Check if you need mattresses/beds, kitchen items, living room furniture, dining room furniture, etc)
Other
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Watauga Long Term Recovery Group v2.
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