Disaster Recovery - Immediate Assistance
By checking the button below you are agreeing to participate in CCA's Disaster Recovery Program.
As a reminder, by submitting this form you authorize Catholic Charities of Acadiana, Love Acadiana, and Acadiana Volunteer Organizations Active in Disaster (AVOAD) member agencies and volunteers to enter my property to attempt to secure and/or mitigate my property to prevent further damage and complete requested work. I further hold these volunteers and their organizations, harmless from any damage or injury that may occur to my property or person in the exercise of this work. I also give my permission for information deemed necessary for the assessment of damage and or repair of my home, person, and/or property to be shared among these agencies and organizations.
I agree
I do not agree
Contact Details
First Name
Last Name
Email
Phone
Physical Address Line 1
Physical
Address Line 2
City
State
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AL
AK
AZ
AR
CA
CO
CT
DE
FL
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OH
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PA
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VA
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Postal Code
Country
Weather Event
Please select...
Hurricane Francine
May 2024 Weather Event
June 2024 Weather Event
Priority
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Low
Med
High
Property Information
Property Type
Please select...
Apartment / Condo
Brick Home
Camper
Mobile Home
Wood Frame
Is this a residence or a business?
Please select...
Business
Residence
Do you rent or own this property?
Please select...
Own
Rent
Is the property insured?
Please select...
Yes
No
Tell us about your household. Please select all that apply.
Are there any children under 3 living at the property?
Yes
Is anyone living at the property disabled?
Yes
Is anyone living at the property elderly?
Yes
Is anyone living at the property medically or otherwise power dependent?
Yes
Tell us about the damage. Please select all that apply.
I do not have electricity.
Yes
There is water coming into my home.
Yes
There is a tree down in my yard / on my property.
Yes
There is a tree down on my home.
Yes
There is debris in my yard / on my property.*
*For debris at the street, your garbage service should be contacted for pick up (call 311 in Lafayette.)
Yes
There is debris on my home.
Yes
My home is a total loss.
Yes
Is there any other information you'd like to share with us?
CCA
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