This form is for Initial Damage Reporting only. If there is an emergency, please dial 911.
This form is sent to the Collier County Emergency Management. THIS IS VOLUNTARY. Your participation helps us collect reports of damages so we have the ability to assess the highest impacted areas. This is not a form for local, state, or federal assistance.
Damage Report Type is required
Address is required
Five digit Zipcode is required
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Please enter the following information if this is your property:
Personal Impact
How many people live in your household?
Contact Information
Please provide the following information about yourself: