Flood Remediation Screening
Was your home flooded by the recent storms on July 6-9, 2021?

Please complete this screening if you need assistance with drying out your home.

Want to volunteer to help others with flood remediation? Please fill out our volunteer form at www.aransashabitat.org/volunteer.

If you need assistance completing this form, please contact 361-450-0131 or aransashabitat@gmail.com.
Email *
Your Full Name *
Spouse/Partner's Full Name (if applicable)
Physical Address (include City, State, Zip) *
Mailing Address (include City, State, Zip) *
Phone number *
Do you Rent or Own? *
What type of structure is the home? *
Please describe in as much detail as possible what is needed right now to make your home safe and dry. *
How did you hear about us? *
A copy of your responses will be emailed to the address you provided.
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