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Report an earthquake you felt !!!
This form is part of a study of the effects of earthquakes. Did you feel an earthquake recently?
If you know of an earthquake that was felt but which you did not personally feel then answer only questions on page 1 and 2, your information will still be useful. Complete questionnaire and submit.

Earthquake Intensity Report Form
Earthquake Unit, U.W.I Mona Campus
(876) 927-2586

Did you feel an earthquake? *
When did the earthquake happen? *
MM
/
DD
/
YYYY
Time
:
What was your address at the time of the earthquake? *
Your answer
Were you ........ *
Required
If indoor , what floor were you on?
Your answer
Height of Building (number of stories)
Your answer
Function of building ( house, school, church etc.)
Your answer
Kind of construction ( brick, stone, wood, concrete etc.)
Your answer
What were you doing *
Required
EARTHQUAKE SHAKING AND SOUND
What best describes the shaking you felt? *
Required
What was the level of shake? *
Required
What best describes any sound you heard?
What was the level of sound?
What best describes what happened where you were (your house, neighbours)?
Did the earthquake cause you to..........?
Did the earthquake wake you?
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