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Member Impact Assessment
Disaster Relief Resources for Members
January 2025 Fires Member Impact Assessment
LAUSD Employee ID Number (Required)
(Required)
Have you been displaced by the fires? (Required)
(Required)
Yes
No
Are you under a mandatory evacuation order? (Required)
(Required)
Yes
No
Did you choose to evacuate for health reasons?
Yes
No
Has your housing been damaged or destroyed?
Yes
No
I don't know yet
Do you own or rent your housing?
Rent
Own
Have you secured a place to stay?
Yes
No
Is it temporary or permanent?
Temporary
Permanent
Other
Does it cost any money?
Yes
No
Do you expect to be unable to return to work for a period of time due to displacement?
Yes
No
How many people in your household are displaced, including children?
Adults
Children
Are any displaced members of your household living with a disability?
Yes
No
Do you need assistance getting connected with resources such as grants for:
Grants for property loss
Grants for emergency expenses
Has your housing been damaged or destroyed?
Yes
No
Do you own or rent your housing?
Rent
Own
Do you have power at home?
Yes
No
Do you have internet access at home?
Yes
No
Are you under a boil water order?
Yes
No
Are you experiencing medical issues related to the fire/evacuation? (Required)
(Required)
Yes
No
Do you expect to be unable to return to work?
Yes
No
Are you currently food insecure?
Yes
No
Is there any additional information you would like us to know?
Non-LAUSD Email (Required)
(Required)
Cell phone (Required)
(Required)
CAPTCHA
