EARTHQUAKE FELT REPORT FORM

This form allows you to report to me information about an earthquake that you have felt. This information allows me to see the variations in shaking intensity from region to region. Shaking intensity is affected by two main features
(1)...Closeness to the quake epicentre and
(2)... the type of ground you are on eg. gravel, soil, rock etc.
NOTE: SUBMIT IS NOW WORKING.
If you feel an earthquake fill out the form as accurately as possible and submit it. Check out my quake page for reports on the latest events recorded events around New Zealand and the SW Pacific region.
Please use this form to report any other problems, ask questions, or provide feedback. In order that I may respond to your comments or questions, please provide us with at least your e-mail address. Thank you.

Email Address:

Your Name:

Location where felt: eg. town, city, suburb, etc

Date/Time:
as accurate as possible please

SHAKING DUR.: SECONDS / RUMBLE HEARD

SHAKING:
STRENGTH AND TYPE OF MOTION

DAMAGE

Please enter any other general comments or questions in the box below.

When you are done:

To clear all input:.