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 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 agreeI do not agree

Contact Details

First Name

Last Name

Phone

Alternate Phone Number

Physical Address Line 1

Physical Address Line 2

City

Postal Code

Property Type

Assistance Needed:

TarpingMudout / Clean outDebris / Tree RemovalComplete Property Loss

Disaster

Contact Information