Polk County Storm Damage Survey- June 12, 2025

This survey is to collect information from Polk County, Texas residents who experienced property damage due to the recent severe thunderstorm. Your response helps Emergency Management assess the impact and coordinate any needed assistance.
This form is for damage assessment purposes only and is not a guarantee of assistance

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* 1. Full Name

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* 2. Phone Number:

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* 3. Email (optional)

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* 4. Street Address of Damaged Property:

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* 5. Type of Home

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* 6. Name of Subdivison
If no subdivison, leave blank.

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* 7. What kind of damage did you experience?

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* 8. Do you Rent or Own the Home? Is the home insured ?

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* 9. Do you have Flood Insurance?

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* 10. Was anyone injured due to the storms?

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* 11. Please provide pictures of any storm damage.

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* 12. Do you need assistance or want to be contacted by Emergency Management?

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