WebEOC Account Request Form

*All fields are required

Last Name:

Please do not add suffixes, for example “III”, “Jr.” ”, etc.

Enter Last Name

First Name:

Please do not add a middle initial.

Enter First Name

Email:

Please provide a work email. Use of a personal email account will possibly delay or prevent approval of the account.

Phone: "xxx-xxx-xxxx"

Please provide a work phone number, where you can be reached.

Please select Agency or County:

Texas State Agency List

Texas County List

Enter Your Agency or County Name

Texas State Agency List:

Please select an Agency.

Your Message:

Please provide information regarding the access you will need in WebEOC. Also provide your job title, supervisor, agency of employment or agency you are assisting.

Enter Your Message

Possible Approver:

Please provide WebEOC Account Approver email, if known. Otherwise leave this blank.