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DID YOU FEEL IT?
Tell us about your earthquake experiences.
ARE YOU PREPARED?
Here is your earthquake safety checklist.
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Skip Navigation LinksHome : Earthquake Feedback Form
DID YOU FEEL IT?
Earthquake Feedback Form

 
This form is to enable you to provide us with feedback on your experience during an earthquake. The information will be used by our scientists to determine the intensity of the earthquake. Sometimes scientists may require additional information, so providing your email address would be very helpful to us.

While many of the questions provide for simple 'select an item' responses, we encourage you to expand on your responses using the text boxes provided.
Name Email Phone
Country City\Village Street Address
1. Did you feel the earthquake?
2. Did others feel the earthquake?
3. When did you feel the earthquake?
/ /   :   
4. Where were your during the earthquake: If other, please explain:
5. If indoors, describe the type of building:
6. What were you doing during the earthquake: If other, please explain:
7. How many seconds did the shaking last?
8. How strong was the shaking?
9. Did any of the following things happen? If other, please explain:
10. Was there any damage to the building where you were? If other, please explain:
11. Describe general effects of the earthquake
12. Please give details about other observations of the earthquake that might be useful.