ORGANIZATION SURVEY

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* 1. Today's Date

Date

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* 2. Name of organization/contact person:

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* 3. Address (Optional)

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* 4. Which flood event were you affected by?

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* 5. How was your organization affected by the floods?

  Was there damage to the organizations building? Has the organization recovered? Did you lose power which caused loss of operations? Did you see an increase in client interactions?
Yes
No

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* 6. How were your clients affected by the flooding?

  Did they have damage to their residence? Did they have loss or damage to personal vehicle(s)? Loss of power (i.e. loss of food, goods, etc.)? Did flooded neighborhood streets prevent evacuation?
Yes
No

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* 7. Did your clients have a loss of employment/or hours worked?

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* 8. Did you have clients experience any Fair Housing Discrimination during or after the flood events? How? Does the organization know the location of discrimination?

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* 9. In general, after any natural or man made disaster, how are your clients affected by the disaster (i.e. flood, hurricane or tornado)? How are their lives affected or systems of care interrupted?

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* 10. In their day to day lives, do your clients experience Fair Housing Discrimination or Civil Rights issues? How/what? Does the organization know the location of the discrimination?

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