Request Disaster Relief from Catholic Charities

Catholic Charities is committed to guiding families who were impacted by disaster to recover as quickly as possible through both immediate and long-term assistance.

If you were impacted by disaster and need assistance, please complete the form below or call 832-240-4658. Please note that an application does not guarantee assistance.

Additional resources and information are available on the Catholic Charities Disaster Recovery Program page.

2020 Disaster Recovery Client Intake Form

Request for Disaster Relief Form

Gender: *
Marital status: *
Primary language: *
Are you a veteran? *
Race: *
Ethnicity: *
Has someone in your household been diagnosed with a disability? *
Household Income: *

Pre-Disaster Housing Situation

Pre-disaster address *
Pre-disaster address
City
State/Province
Zip/Postal
Country
Pre-disaster housing type:
Pre-disaster living situation: *
Pre-disaster insurance status: *
Damage Assessment: *
Damage Verification Source: *

Post-Disaster Housing Situation

Post-disaster address *
Post-disaster address
City
State/Province
Zip/Postal
Country
Post-disaster housing type:
Post-disaster living situation: *
Post-disaster insurance: *
Damage Assessment: *
Damage Verification Source: *

Impact of Disaster

Are you eligible for FEMA assistance? *
Are you eligible for Disaster Unemployment assistance? (NOTE: Your answer to this question will not impact your ability to receive assistance from Catholic Charities. See additional information from IRS.gov and the Texas Workforce Commission.) *
Impact of disaster (check all that apply):

Assistance Requested

Check all that apply: *

Acknowledgement and Consent for Services

I, the undersigned, hereby authorize the release of information to Catholic Charities of the Archdiocese of Galveston-Houston for the purpose of determining program eligibility and monitoring program compliance. (The disclosures made are limited to the information listed here: Houston Food Bank; United Way.) By selecting "yes, I agree" below, I am acknowledging that I have read and understood Catholic Charities'eligiblity forms prior to submitting this application for assistance. (Read and review the consent information: ENGLISH | SPANISH). *