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HTML Popup Type: esriServerHTMLPopupTypeAsHTMLText
first_please_provide_your_name (type: esriFieldTypeString, alias: First, please provide your name, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
what_is_your_address (type: esriFieldTypeString, alias: What is your address?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
what_is_your_phone_number (type: esriFieldTypeString, alias: What is your phone number?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
what_is_your_email (type: esriFieldTypeString, alias: What is your email?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
if_you_have_insurance_does_it_c (type: esriFieldTypeString, alias: If you have insurance, does it cover this type of situation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [I_do_not_have_insurance: I do not have insurance])
do_you_rent_or_own_the_property (type: esriFieldTypeString, alias: Do you rent or own the property?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Rent: Rent], [Own: Own])
do_you_have_a_disability_or_fan (type: esriFieldTypeString, alias: Do you have a disability or FAN?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
which_best_describes_the_reside (type: esriFieldTypeString, alias: Which best describes the residence?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Manufactured: Manufactured], [Conventionally_Built: Conventionally Built])
do_any_of_the_following_apply (type: esriFieldTypeString, alias: Do any of the following apply?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_the_roof_missing_or_collapse (type: esriFieldTypeString, alias: Is the roof missing or collapsed?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
has_the_residence_been_moved_of (type: esriFieldTypeString, alias: Has the residence been moved off the blocks or foundation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
select_any_items_that_suffered_ (type: esriFieldTypeString, alias: Select any items that suffered damage that occurred as a direct result of the incident, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
is_there_anything_besides_the_f (type: esriFieldTypeString, alias: Is there anything besides the foundation that remains?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
will_the_residence_require_demo (type: esriFieldTypeString, alias: Will the residence require demolition due to being unsafe or by confirmed imminent danger?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
have_any_walls_collapsed_or_fai (type: esriFieldTypeString, alias: Have any walls collapsed or failed?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_there_damage_to_the_foundati (type: esriFieldTypeString, alias: Is there damage to the foundation including bulging, collapsing, or major cracks?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
has_the_residence_shifted_more_ (type: esriFieldTypeString, alias: Has the residence shifted more than six inches off the foundation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_there_damage_to_the_roof_cov (type: esriFieldTypeString, alias: Is there damage to the roof covering or roof structure?`, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_there_damage_to_drywall_or_i (type: esriFieldTypeString, alias: Is there damage to drywall or insulation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
are_there_small_cracks_in_the_f (type: esriFieldTypeString, alias: Are there small cracks in the foundation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_there_damage_to_the_furnace_ (type: esriFieldTypeString, alias: Is there damage to the furnace, air conditioner, water heater, etc.?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
is_there_damage_or_contaminatio (type: esriFieldTypeString, alias: Is there damage or contamination to a private well or septic system?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
check_all_that_apply (type: esriFieldTypeString, alias: Check all that apply, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)