Drought Assessment Survey Form
Please complete this survey to help assess the impact and severity of drought conditions in your area. Your responses will inform planning and support efforts.
Location (Town/Area Name)
*
How would you rate the current severity of drought in your area?
*
1
2
3
4
5
Which of the following impacts have you observed due to drought? (Select all that apply)
*
Reduced crop yields
Water shortages
Livestock health issues
Soil degradation
Economic losses
Migration/displacement
Other
Please indicate the primary water sources in your area and their current status.
*
Rows
Fully Available
Partially Available
Not Available
Wells
1
2
3
Rivers/Streams
4
5
6
Rainwater Tanks
7
8
9
Municipal Supply
10
11
12
How has the drought affected agricultural activities in your area?
*
No impact
Minor impact
Moderate impact
Severe impact
Which coping strategies are being used in response to drought? (Select all that apply)
Water conservation
Crop diversification
Irrigation improvements
Livestock reduction
Migration for work
Other
Have you received any assistance related to drought relief?
*
Yes
No
If yes, what type of assistance did you receive?
Water delivery
Food aid
Agricultural inputs
Financial support
Other
On a scale of 1 to 10, how urgent is the need for drought relief in your area?
*
Not urgent
1
2
3
4
5
6
7
8
9
Extremely urgent
10
1 is Not urgent, 10 is Extremely urgent
Please share any additional comments or observations regarding drought conditions.
Submit Survey
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