Felt report form for Community Internet Intensity Maps

DID YOU FEEL IT?   REPORT IT HERE!

You can help provide information about the extent of shaking and damage for earthquakes in Canada. The specific details you may provide will help us determine how your area may respond to future earthquakes.

While identifiers such as name, e-mail address, and telephone are optional, please provide as complete address information as possible to help us locate the intensity in your area.

Personal Information Collection Statement

The personal information you provide using the Felt report form for Community Internet Intensity Maps is collected under the authority of the Resources and Technical Surveys Act and will be used by Natural Resources Canada to conduct research into earthquakes in Canada. The information may also be used to contact you for follow-up research or to confirm the data provided.

Please note that the information you provide using the Felt report form for Community Internet Intensity Maps may be routed through an American or other internationally-based server. However, in the event that this occurs, the information will be deleted from the American or internationally-based server after one week.

There are no legal or administrative consequences for refusing to provide the personal information requested. Under the Privacy Act, you have rights of access to, correction of, and protection of personal information.

The information you provide using this form is described in the following standard Personal Information Bank (PIB): Public Communications - PSU 914. For more information about this PIB and your privacy rights, please consult Info Source: Sources of Federal Government and Employee Information, which is published on the Internet by the Treasury Board of Canada Secretariat at: http://infosource.gc.ca/index-eng.asp.

How can we contact you?

For other events or historic events, go to the GSC CIIM archive. If you were in the U.S.A. at the time of the earthquake, please go to the USGS earthquake site to locate the appropriate form.







Where did you feel it?

Since you are submitting this form for a new or unknown earthquake, please fill out the following information completely. This will help us accurately locate this event.

Your location when the earthquake occurred:














When was it?

Please fill out as completely as you can:

Date of earthquake

Time of earthquake

Where were you?

While answering all these questions is optional, we encourage you to fill out as many as possible so we can provide a more accurate intensity estimate.









Did you feel the earthquake?
If you were asleep, did the earthquake wake you up?



Your experience of the earthquake:













Earthquake effects:















If you were inside, was there any damage to the building? Check all that apply.
All damage types.















Additional Comments:

You may use the next box to clarify answers or to make observations that are not accommodated by other questions. You may also use the following box to give first-person descriptions of how the earthquake affected you. GSC scientists may use some of the information that you enter in qualitative descriptions of shaking or damage in GSC publications. You would be identified as "an observer" and your location would be given in general terms. Parts of some first-person accounts may be reproduced as quotations in GSC publications.

To submit your completed form, press this button: