* 1. In which neighborhood do you live? Please use the box below to indicate the block of your residence (example: 100 block of T Street, NW).

* 2. Did you experience flooding Thursday, July 19, 2012? If yes, please use the box below to provide a description and the cost of damage to your residence and/or personal property.

* 3. Did you experience flooding Wednesday, July 18, 2012? If yes, please use the box below to provide a description and the cost of damage to your residence and/or personal property.

* 4. Did you experience flooding Tuesday, July 10, 2012? If yes, please use the box below to provide a description and cost of the damage to your residence and/or personal property.

* 5. Prior to Tuesday, July 10, 2012, when was the last time you experienced flooding? Please indicate how long you have lived in Bloomingdale/LeDroit Park.

* 6. How often do you experience flooding?

* 7. Please select each answer that describes flooding in your residence:

* 8. Please tell us about any measures you have taken to prevent or mitigate flood damage. What was the cost of those measures? How successful have your efforts been?

* 9. If applicable, please tell us whether you have sought compensation for the cost of damage from DC Water or your insurance company. If yes, what was the outcome?

* 10. If you wish to be included in future communications regarding flooding in Bloomingdale/LeDroit Park, please provide your email address and any additional contact information you wish to provide.

T