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Felix Insurance Planning
Homeowners Loss Report
We're sorry to hear you have experienced a loss. Please call our office or use the form below to contact us. One of our agents will assist you.
Your Full Name:
Email Address:
Telephone Number:
Cell Phone Number:
Date of Loss: (mm/dd/yy)
Location of Loss:
Description of Loss:
Police or Fire Department Notified?
Yes
No
If Yes Please Specify:
Is Property Habitable?
Yes
No
If NO Where are you planning to stay and where can we reach you?
Any Additional Information Not Requested Above:
Please Note: Submitting this form via the website does not constitute a "formal" claim. Please contact us or your insurance company to notify of a loss.
Do not enter anything in this field:
