Community Impact Assessment

After a disaster, Manitoba EMO requires information to determine the impacts on your community. This is necessary to evaluate the immediate assistance that might be required, to ensure your impacts are included in the broader assessment of damages, and to begin evaluating the possibility of Disaster Financial Assistance (DFA).

Please complete the Community Impact Assessment below as soon as you are confident about the accuracy of your information. Often, Manitoba EMO will ask you to complete a Community Impact Assessment - but, if you have reliable information available earlier, don't wait for us to ask. Our experience is that the Assessment will be more accurate if it is done shortly after an event. The longer you wait, the harder it is to re-construct what has happened.

Remember, the Community Impact Assessment is only a preliminary assessment of damages. It can be modified or updated, and it will certainly become more detailed once you've had a chance to carefully inspect damages. The information you provide at this point does not limit or determine the level of assistance that might be made available. A request from Manitoba EMO to provide a Community Impact Assessment should not be taken as an indication that DFA will be provided.

Your information will be treated as confidential and will only be used internally by Manitoba EMO.

Complete a Community Impact Assessment:

  • Complete and submit the on-line Community Impact Assessment form below, or
  • Download the form (PDF, 35KB). Fax or mail the completed form to EMO.

Should you have any questions about the Community Impact Assessment, please contact us.

Items marked with asterisk (*) are required to submit the application.

Local Authority Information

Local Authority*:
Contact Person Name:
     Position/Title:
     Email:
     Phone Number:
Alternate Contact Name:
     Alternate Position/Title:
     Alternate Email:
     Alternate Phone Number:

Event

Type*:
(e.g. flood, heavy rains, wind storm, etc.)
Date of event *:
(yyyy/mm/dd)
Description:

Pre-emptive actions and activities (evacuations, diking, etc.)

Number of persons evacuated:  
Pre-emptive actions (briefly describe actions taken to prevent or reduce damages):

Damages

Private Property (Private Sector)

Minor Damage Major Damage Destroyed
Number of Homes:
Number of Farm Operations:
Number of Businesses:
Describe damages (e.g. basement and/or main floor flooding, wind and rain damages, fire losses, etc.):

Public Property (Public Sector)

Damage to Buildings (owned by local authority)

Building and damage description (include the building description (use) and description of damage to each building):

Municipal Infrastructure (Public Sector)

Number of bridges damaged:

Minor:
Major:
Destroyed:

Engineer Reports or contractor estimates:

Number of site(s) that require engineer reports or contractor estimates:

Total number of damaged sites:

Total number of all damaged sites (bridges, road washouts, culverts and drainage system damages):

Estimated damages:

Total estimated damage for all sites:
$

Comments and Additional Information

 to EMO or

 to reset

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