{"id":179,"date":"2025-01-18T01:44:20","date_gmt":"2025-01-18T01:44:20","guid":{"rendered":"http:\/\/www.pike911.org\/?page_id=179"},"modified":"2025-02-20T01:11:03","modified_gmt":"2025-02-20T01:11:03","slug":"damage-assessment","status":"publish","type":"page","link":"http:\/\/www.pike911.org\/index.php\/damage-assessment\/","title":{"rendered":"Damage Report"},"content":{"rendered":"\n<h2 class=\"wp-block-heading alignfull has-text-align-center has-theme-palette-9-color has-text-color has-background has-link-color wp-elements-b153e937fe7108cd149b3e568512fe51\" style=\"background-color:#160972\">Damage Report<\/h2>\n\n\n\n<p>Complete the form below to request to have any damage occurred to your property that was caused by a natural disaster. Someone from our office will be in contact with you as soon as possible or you can reach us directly at <a href=\"tel:6064320210\">(606) 432-0210<\/a> or <a href=\"tel:6064374126\">(606) 437-4126<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading alignwide has-text-align-center has-theme-palette-9-color has-text-color has-background has-link-color wp-elements-a240a579a4e50e6da141ad143cfc53d4\" style=\"background-color:#d10914\">If you are in immediate danger call 911!<\/h3>\n\n\n<div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-a26571f7-9170-4baf-9906-dfbb76cb1a86 wpforms-render-modern\" id=\"wpforms-1068\"><form id=\"wpforms-form-1068\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"1068\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/179?wpforms_form_id=1068\" data-token=\"ab39157a1467fe0819d619468681f90d\" data-token-time=\"1777652796\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-1068-field_12-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"12\"><fieldset><legend class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1068-field_12\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][12][first]\" aria-errormessage=\"wpforms-1068-field_12-error\" required><label for=\"wpforms-1068-field_12\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1068-field_12-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][12][last]\" aria-errormessage=\"wpforms-1068-field_12-last-error\" required><label for=\"wpforms-1068-field_12-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-1068-field_23-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-1068-field_23\">Phone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-1068-field_23\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][23]\" aria-label=\"Phone\" aria-errormessage=\"wpforms-1068-field_23-error\" required><\/div><div id=\"wpforms-1068-field_6-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1068-field_6\">Email<\/label><input type=\"email\" id=\"wpforms-1068-field_6\" class=\"wpforms-field-large\" name=\"wpforms[fields][6]\" spellcheck=\"false\" aria-errormessage=\"wpforms-1068-field_6-error\" ><\/div><div id=\"wpforms-1068-field_24-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"24\"><fieldset><legend class=\"wpforms-field-label\">Address of Damage <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1068-field_24\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][24][address1]\" aria-errormessage=\"wpforms-1068-field_24-error\" required><label for=\"wpforms-1068-field_24\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-1068-field_24-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][24][address2]\" aria-errormessage=\"wpforms-1068-field_24-address2-error\" ><label for=\"wpforms-1068-field_24-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1068-field_24-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][24][city]\" aria-errormessage=\"wpforms-1068-field_24-city-error\" required><label for=\"wpforms-1068-field_24-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-1068-field_24-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][24][state]\" aria-errormessage=\"wpforms-1068-field_24-state-error\" required><option class=\"placeholder\" value=\"\" selected disabled>&#8212; Select state &#8212;<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-1068-field_24-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1068-field_24-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][24][postal]\" aria-errormessage=\"wpforms-1068-field_24-postal-error\" required><label for=\"wpforms-1068-field_24-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-1068-field_25-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-1068-field_25\">Date of Incident <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-1068-field_25\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][25][date]\" aria-errormessage=\"wpforms-1068-field_25-error\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div>\t\t<div id=\"wpforms-1068-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-1068-field_1\" >Damage Damage Picture<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-1068-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-1068-field_18-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-1068-field_18\">Type of Damage <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1068-field_18\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][18]\" placeholder=\"Briefly describe the damage.\" aria-errormessage=\"wpforms-1068-field_18-error\" required><\/textarea><\/div><div id=\"wpforms-1068-field_26-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-1068-field_26\">Upload a Picture of the Damage (optional)<\/label><div\n\t\tclass=\"wpforms-uploader \"\n\t\tdata-field-id=\"26\"\n\t\tdata-form-id=\"1068\"\n\t\tdata-input-name=\"wpforms_1068_26\"\n\t\tdata-extensions=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,avif,ico,heic,heif,heics,heifs,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,x-wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages\"\n\t\tdata-max-size=\"104857600\"\n\t\tdata-max-file-number=\"20\"\n\t\tdata-post-max-size=\"2097152\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div 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Upload<\/span>\n\t\t\t\t\t<\/span>\n\n\t\t\t\t\t<span class=\"modern-hint\">You can upload up to 20 files.<\/span>\n\t\t\t<\/div>\n<\/div>\n\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-1068-field_26\"\n\t\tname=\"wpforms_1068_26\" \t\tvalue=\"\">\n<\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-1068-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-1068-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page 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height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"<p>Damage Report Complete the form below to request to have any damage occurred to your property that was caused by a natural disaster. Someone from our office will be in contact with you as soon as possible or you can reach us directly at (606) 432-0210 or (606) 437-4126. If you are in immediate danger&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"footnotes":""},"class_list":["post-179","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/pages\/179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/comments?post=179"}],"version-history":[{"count":8,"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/pages\/179\/revisions"}],"predecessor-version":[{"id":1577,"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/pages\/179\/revisions\/1577"}],"wp:attachment":[{"href":"http:\/\/www.pike911.org\/index.php\/wp-json\/wp\/v2\/media?parent=179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}