Community Hazard Assessment Quiz Form
Use this form to assess common community hazards, awareness, and overall risk conditions in a clear, straightforward quiz format.
Community Details
Respondent Name
*
Organization / Neighborhood
Location of Area Being Assessed
*
Hazard Quiz Questions
Which hazard type is most commonly seen in your community?
*
Flooding
Fire
Landslides
Severe Storms
Heatwaves
Other
How often are hazards observed in your area?
*
Daily
Weekly
Monthly
A few times a year
Rarely
Never
How severe are the hazards typically when they occur?
*
Minor
1
2
3
4
5
6
7
8
9
Extreme
10
1 is Minor, 10 is Extreme
How familiar are community members with local hazard preparedness measures?
*
Very familiar
Somewhat familiar
Neutral
Somewhat unfamiliar
Very unfamiliar
Rate the preparedness level for each hazard type in your community
*
Rows
Well prepared
Somewhat prepared
Not prepared
Flooding
1
2
3
Fire
4
5
6
Landslides
7
8
9
Severe storms
10
11
12
Heatwaves
13
14
15
Overall Assessment and Follow-up
Overall Risk Rating
*
Low Risk
1
2
3
4
5
6
7
8
9
High Risk
10
1 is Low Risk, 10 is High Risk
Additional Notes or Recommended Actions
Submit Quiz
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