Citizen Service Request Form

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.