Fire Department Incident Request

Please fill out the form below to detail the level of need and emergency assistance for fire, flood or other disaster

Full Name of Affected Family or Responsible Party*

Phone Contact of Responsible Party*

Address of Community Hazard*

Zip Code*

Requesting Fire Department, Law Enforcement or public agency*

Incident Commander Name, Contact, (requesting party name if IC unavailable)*

Description of Need (Incident support, victim services, board up or CAN)*

Hazard Type*

Structure Fire

Commercial Fire

Wildland Fire Impacting Structure

Vehicle/Object Impact to Structure

Open and Unsecure Structure

Natural Disaster Affecting Structure (Explain Below)

Weather Disaster Affecting Structure (Explain Below)

Physical Disaster Affecting Structure(Explain Below)

Explanation of Natural, Weather, Physical or Other Disaster Affecting Structure

Emergency Response Team Priority*

Immediate

Delayed (2-4 hrs)

Scheduled (Later or Next Operational Period)

Phone Consult Only

Landline for more detail

Email address*

Location*

info@internationalfirefoundation.org

EIN: 99-0435238

Community Leader Resources