The PATCH Guide Request Form

Name

First NameLast Name

Organization/Agency Name

Title/Role

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What type of organization are you representing?

Has your community recently experienced a disaster and/or is your organization currently involved in disaster recovery efforts?

What is your primary reason for requesting the PATCH Guide?

Disclaimer Acknowledgement

The PATCH Guide was developed based on Linn County’s unique disaster recovery experience following the 2020 derecho. While this guide is intended to provide a replicable framework and practical lessons learned, communities should adapt the information to fit their own local laws, funding requirements, organizational structures, and disaster circumstances. LAP-AID does not guarantee specific outcomes and encourages communities to consult legal, financial, and disaster recovery professionals when implementing similar programs.

Signature

The PATCH Guide Request Form

I have read and understand the following disclaimer: