Hazard Report Form
A Hazard report form is an official document that provides details of a natural hazard, its causes, impact and further information about the calamity. These types of forms are generally prepared by weather or hazard response departments. This report form helps to investigate and analyze the nature of hazard.
Sample Hazard Report Form
General Information
Title of Department/Agency concerned for hazard Report______________________
Address______________ Phone__________ Email_________ Fax____________
Report prepared by: Name____________ Designation___________
Address__________ Phone__________
Hazard Report Information
Date of Hazard___/___/__ Duration: Hours/Days/Week______________
Type of Hazard: Natural/Man Made____________
Flood/Earthquake/Wild Fire/Cyclone/Land Slide/Other_____________________
Brief Description of Hazard_____________________
Major causes of hazard___________
Effected Areas/Region_________________
Damage it caused_____________________
Loss of Infrastructure__________________
Loss of lives: Man/Animal______________
Loss to Environment___________________
Impact on Natural Resources________________
Post Impact on Human Health__________________
Corrective Actions taken by local authorities____________________
Total cost of damage in monetary terms________________________
Any compensation announced for people___________________
List the reconstruction efforts started by local authority_____________
List of preventive measures______________
Signature___________ Date of Report Submission____/____/____
Report Submitted to: Name_________ Signature____________
Category: Report Forms
