Halloform
Customer Support

Citizen Service Request form template

See something that needs fixing? Report non-emergency issues like potholes, broken streetlights, graffiti, or illegal dumping. Add a photo and the location and your request is routed to the right department with a tracking number. You'll get updates as crews respond. For emergencies, always call your local emergency number instead.

Tracked requestPhoto upload
Open preview in new tab

What’s in the box

Pinpoint the spot

Add the address and a photo so crews find and fix the issue faster.

Track your request

Every report gets a tracking number and status updates by email.

Right department, first try

We route your report to the correct crew automatically based on the issue type.

Perfect for

  • A driver reporting a dangerous pothole
  • A walker reporting a streetlight that's out
  • A resident flagging graffiti on a wall
  • A neighbor reporting illegal dumping

Other templates you might like

Browse all β†’

Start with Citizen Service Request, ship today

Free forever for up to 1,000 submissions a month. No credit card.

Use this template