Complete this anonymous questionnaire to get the most accurate, personalized list of possible assistance. The following questions are directly related to disaster assistance. Please answer them to the best of your ability or skip if not applicable. After you answer these questions, you may return to this tab to change your responses if needed.

1. As a result of this disaster, do you need assistance in any of the following categories?
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2. What describes your housing/living situation prior to the disaster?
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3. Has your home flooded as a result of this disaster?
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4. Have you or a member of your household experienced life-changing events as a result of this disaster? Check all that apply. If none apply, skip this question.
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5. Are you or a member of your household any of the following? Check all that apply. If none apply, skip this question.
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6. Are you or a member of your household receiving government assistance or benefits (for example, Housing Choice Voucher Program (Section 8) assistance, Social Security benefits, etc.)?
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7. Are you or one of your direct dependents a U.S. citizen or a non-citizen with eligible immigration status?
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8. Are you or a member of your household enrolled in a federally recognized American Indian Tribe or Alaska Native Tribe?
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9. At the time of the disaster, of what state, territory or tribal land were you a primary, legal resident?
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