Forms • Brazos County, TX • CivicEngage

Contact Us If You Experienced Flooding
Please answer the following questions in order to provide Brazos County Emergency Management staff with information that can be used to better understand the causes of, and any potential solutions to, flooding issues on your property within the cities of Kurten, Wixon Valley and the unincorporated areas of Brazos County.

Last Name:*

Address:*

Address Line 2:

City:*

State / Province / Region:*

Postal / Zip Code:*

Email*

Phone: *

How Long Have You Been at this Address?*

What is the Approximate Age of the Home or Business?*

Date of Flooding Event:*

Did Water Enter Your House?*

Yes

No

Are You a Tenant or Property Owner of the Location Where Flooding Occurred?*

Tenant

Property Owner

How Many Inches of Water Entered the Home?*

How Did the Water Enter the Structure?
For example: Was it through a roof leak, or because of rising water from the street, a nearby creek, or neighboring property?*

Has Your Home Flooded Previously?*

Yes

No

If Yes, When Was the Date of the Most Recent Flood Event?

How Many Times Since You have Lived in the Home has Water Entered?*

Estimate the Average Depth of Water in the Home Since You Have Lived There?*

Is Your Home Located in the 100-Year Floodplain?*

	Yes
	No

Unsure

Do You Have Homeowners' Insurance?*

Yes

No

Do You Also Have Flood Insurance?*

Yes

No

If Yes (on Flood Insurance) Have You Filed a Claim for This Most Recent Flood Event?

Have You Received an Estimate for Assessed Storm Damage from a Licensed Contractor or Insurance Adjuster?*

Yes

No

If Yes, What is the Amount of the Estimate for Repairs?

Have You Taken Any Action Since Living There to Alleviate the Problem?*

Yes

No

If Yes, Please Briefly Explain the Actions That Have Been Taken

Would You Like a Brazos County Representative to Contact You Concerning This Flooding Issue?*

Yes

No

Did you have any other property damage not caused by flooding?*

Yes

No

If Yes, Please Briefly Explain any Damage and Cause of Damage

* indicates required fields.

Live Edit

Contact Us

Quick Links

Helpful Links