Apply for Flood Relief — West Side Long Term Recovery Group

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Did you experience flooding between June 29th and July 2nd, 2023?

Do you still have damage in your basement from the flooding? This form is to be able to better assess what you may need assistance with and try to pair you with services.

Please fill out the form below and we will be in touch.

Name

First Name

Last Name

Address

Address where flooding happened

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Removal of Damaged Items

Do you have items in your basement that were damaged in the flood and need to be removed?

Water Damage

Do you still have water damage in your basement?

Mold

Do you see mold in your basement?

Describe the damage in your basement

Please explain how the flooding affected your basement and any damages that remain at this time

Other Information

Is there anything else we should know about your flooding situation?