Public · free template

Citizen Service Request Form

Log resident service requests with location, category and evidence.

A ready-to-use government & public sector form for councils, agencies and public bodies: 15 questions, 3 pages, 3 conditional rules.

Questions
15
Pages
3
Layouts
classic
Conditional rules
3
Preview it in the gallery

Searches this template answers

Also filed under

Live preview and test console

This is the real form. Answer it to test the 1 conditional rule — nothing is sent or stored.

Page 1 of 3About you

Report a problem or request a service

Include your country code.

Would you like a response?

Every question on this page is currently visible.

Compliance checklist

Ready to publish
  • Payment items priced — passingEvery payment question charges a real amount, so a submission always records a payment.
  • Conditional logic resolves — passingEvery rule points at a question or page that exists in this template.
  • Legal text not required — passingThis template collects neither health nor regulated financial information.
  • Question labels unique — passingLogic and exports address questions by label, so duplicates are ambiguous.

What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.

Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.

Who this template is for

Citizen Service Request Form is built for councils, agencies and public bodies who need to run a public request or application to a consistent standard.

  • Councils, agencies and public bodies working in government & public sector.
  • Teams who need to run a public request or application to a consistent standard without writing code or paying for a custom build.
  • Anyone replacing paper forms that are slow to process and hard to audit with one structured record per enquiry.
  • Respondents are residents and applicants — the form asks them 15 questions across 3 screens.

Why this form is useful

It removes the cost of paper forms that are slow to process and hard to audit and turns each submission into a record your team can act on immediately.

  • 7 questions are required, so submissions arrive complete instead of needing a follow-up email.
  • It collects a verified email address so replies and confirmations land.
  • It captures a phone number for urgent follow-up.
  • It accepts a document or photo upload as evidence.
  • It pins the request to a specific date.
  • It captures a full postal address.
  • Conditional logic hides 3 questions until they are relevant — shorter forms convert better than long ones.
  • Splitting the form across 3 pages keeps each screen short and shows respondents how much is left.

How to use this template

From copy to live form is a few minutes of work, and every step is reversible.

  1. 1Press “Use this template” — a fresh copy of Citizen Service Request Form lands in your workspace, ready to edit.
  2. 2Rename or delete any question, and change what is required. Nothing here is fixed.
  3. 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
  4. 4Check the upload limits on the file question so respondents can attach what you actually need.
  5. 5Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
  6. 6Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.

Logic and conditions blueprint

Exactly how this form behaves as it is answered — 3 conditional rules ship with it.

  • Features advanced show logic: if “Is this an immediate danger to the public?” is Yes, the form dynamically exposes “Describe the hazard”. Otherwise that question never appears.
  • Features conditional validation: if “Have you reported this before?” is Yes, “Previous reference number” becomes mandatory before the form can be sent.
  • Features conditional validation: if “Would you like a response?” is Yes, “Email address” becomes mandatory before the form can be sent.
  • All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

About this template

Councils and municipal teams receive service requests through every channel imaginable, and this form is designed to turn them into a consistent, routable queue. The resident identifies themselves and gives a contact method, or can flag the request as anonymous where your policy allows it. The request itself is categorised — highways and potholes, street lighting, waste and recycling, fly tipping, parks and trees, drainage, noise, abandoned vehicles or other — because the category is what determines which department receives it. Location is captured as a street address plus an optional what3words or nearest landmark, and the resident can upload photographs, which dramatically reduces the number of inspection visits needed before work is scheduled. Severity and safety questions identify anything that is an immediate hazard so it can be escalated rather than queued. Finally the resident says whether they have reported this before and gives any previous reference number, which stops duplicate cases being opened. Submissions arrive time-stamped with a reference the resident can quote.

What this form asks

Every question is editable — rename it, make it optional, or delete it entirely.

Page 1 — About you

  • Your namerequired
  • Email addressrequired
  • Contact number
  • Your address
  • Would you like a response?required

Page 2 — Your request

  • Request categoryrequired
  • Describe the issuerequired
  • Is this an immediate danger to the public?required
  • Describe the hazard
  • Have you reported this before?required
  • Previous reference number

Page 3 — Location and evidence

  • Location of the issue
  • Nearest landmark or what3words
  • Photographs
  • Date you first noticed it

15 questions in total.

How the form changes as it's filled in

This template ships with 3 conditional rules, grouped into 3 behaviours driven by 3 questions. Everything below is already set up — edit or delete any rule once the template is in your workspace.

Driven by “Is this an immediate danger to the public?

  • Reveals questions

    If “Is this an immediate danger to the public?” is Yes, the form reveals “Describe the hazard”.

Driven by “Have you reported this before?

  • Makes answers required

    If “Have you reported this before?” is Yes, “Previous reference number” becomes required before the form can be submitted.

Driven by “Would you like a response?

  • Makes answers required

    If “Would you like a response?” is Yes, “Email address” becomes required before the form can be submitted.

Works in this layout

These pages cover the same subject ground as the citizen service request form, matched on the words people actually search for.

Frequently asked questions

Can residents report anonymously?

Yes — the response question lets them log an issue without asking for a reply, and you can make name and email optional.

How do requests reach the right team?

Use the category answer to route notification emails, so highways and waste requests land in different inboxes.

Does it prevent duplicate reports?

A conditional question asks for a previous reference number, letting your team merge rather than open a new case.

Can we publish it on our council website?

Yes — the form embeds in any page or can be linked directly from your services index.

Is the Citizen Service Request Form template free to use?

Yes. You can preview and test Citizen Service Request Form on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.

What does the Citizen Service Request Form template ask for?

It asks 15 questions across 3 pages, 7 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.

Can I edit the Citizen Service Request Form form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic layout, restyle it to match your brand, and set who gets notified on each submission.

How does the conditional logic in this government & public sector form work?

3 conditional rules ship with the template: Features advanced show logic: if “Is this an immediate danger to the public?” is Yes, the form dynamically exposes “Describe the hazard”. Otherwise that question never appears. Features conditional validation: if “Have you reported this before?” is Yes, “Previous reference number” becomes mandatory before the form can be sent. Features conditional validation: if “Would you like a response?” is Yes, “Email address” becomes mandatory before the form can be sent. All rules are editable in the Logic tab.

Where do responses to the Citizen Service Request Form form go?

Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.

Can I embed the Citizen Service Request Form form on my own website?

Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.

Can respondents upload files?

Yes. This template includes a file upload question, so respondents can attach documents or photos with their answers. You can adjust the accepted file types and size limits on that question.

More forms teams pair with the citizen service request form.

Related categories