Public · free template

Pothole Report Form

One-screen pothole report: the road and nearest landmark, the size and depth of the hole, where it sits in the lane and whether damage has occurred.

A ready-to-use government & public sector form for councils, agencies and public bodies: 15 questions, 1 page, 3 conditional rules.

Questions: 15
Pages: 1
Layouts: classic · card
Time to complete: ≈ 2 min
Conditional rules: 3

Preview it in the gallery

Searches this template answers

Also filed under

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

Pothole Report 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 1 screen.
Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

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.

10 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 accepts a document or photo upload as evidence.
Conditional logic hides 3 questions until they are relevant — shorter forms convert better than long ones.
Every response is stored, searchable and exportable, so nothing depends on one person's inbox.

How to use this template

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

1Press “Use this template” — a fresh copy of Pothole Report Form lands in your workspace, ready to edit.
2Rename or delete any question, and change what is required. Nothing here is fixed.
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.
4Check the upload limits on the file question so respondents can attach what you actually need.
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.
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 conditional validation: if “Has it already caused damage or injury?” is Yes, “What happened, and when?” becomes mandatory before the form can be sent.
Features advanced show logic: if “Where is it?” is On the pavement or footpath, the form dynamically exposes “Is there room to walk around it?”. Otherwise that question never appears.
Features advanced show logic: if “Roughly how deep is it?” is Deeper than a brick, the form dynamically exposes “Is there anything to warn drivers or cyclists?”. Otherwise that question never appears.
All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

About this template

Highways teams prioritise road defects by size, depth and position, so a report that captures those three things can be assessed without an inspection visit first. This single screen asks for the road name, the nearest house number or landmark and the direction of travel, which together locate a defect closely enough to find. It then asks what the resident sees: a pothole, a sunken drain cover, a crumbling edge or a raised slab, roughly how wide it is, roughly how deep using everyday comparisons rather than millimetres, and where it sits — in a wheel track, at a junction, in a cycle lane or on the pavement. Two further questions matter for triage: whether it is on a bus or cycle route, and whether anyone has already been damaged or injured by it, which routes the report differently. A photograph with something for scale helps most. Inspection standards, intervention levels and repair times are set by each authority.

What this form asks

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

Report a pothole

Road namerequired
Nearest house number or landmarkrequired
Town or arearequired
Which direction are you travelling?
What kind of defect is it?required
Roughly how wide is it?required
Roughly how deep is it?required
Where is it?required
Is there room to walk around it?
Is it on a bus or cycle route?required
Has it already caused damage or injury?required
What happened, and when?
Is there anything to warn drivers or cyclists?
Upload a photo, with something for scale if you can
Email address if you would like an updaterequired

15 questions in total.

Example of a completed pothole report form

This sample shows how a resident reports a road defect.

Road name: Station Approach
Nearest house number or landmark: Opposite the newsagent
Town or area: Preston
What kind of defect is it?: Pothole
Roughly how wide is it?: 40cm
Roughly how deep is it?: 8cm
Where is it?: Middle of the left-hand lane
Is it on a bus or cycle route?: Yes
Has it already caused damage or injury?: Yes

Sample data — no real people, addresses or records are shown.

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 “Has it already caused damage or injury?”

Makes answers required
If “Has it already caused damage or injury?” is Yes, “What happened, and when?” becomes required before the form can be submitted.

Driven by “Where is it?”

Reveals questions
If “Where is it?” is On the pavement or footpath, the form reveals “Is there room to walk around it?”.

Driven by “Roughly how deep is it?”

Reveals questions
If “Roughly how deep is it?” is Deeper than a brick, the form reveals “Is there anything to warn drivers or cyclists?”.

Set it up step by step

1
Use everyday size comparisons
Asking for depth in millimetres produces guesses; a brick and a dinner plate produce answers an inspector can actually rank.
2
Capture position in the lane
A defect in a wheel track or a cycle lane is treated differently from one at the kerb, and residents can answer that instantly.
3
Route damage reports separately
A report that mentions damage or injury usually starts a claims process as well as a repair, so it should not sit in the general queue.
4
Ask for a photo with scale
A coin or a shoe in the frame turns a photograph into a measurement, and people will do it if you ask.

Mistakes to avoid

Asking for measurements in millimetres, which nobody standing on a road can give accurately.
Collecting the road name only, so an inspector cannot find the defect.
Handling damage claims and repair reports in the same queue.

What it pairs with

Most teams don't run this form on its own. These are the forms and systems it sits next to.

What to do with the responses

Rank reports by depth and position, send damage or injury reports to the claims process as well as the repair queue, and close the loop with anyone who left an email address.

Works in both layouts

Browse classic templates Browse card templates

Forms that overlap this one

These pages cover the same subject ground as the pothole report form, matched on the words people actually search for.

Frequently asked questions

How is this different from the quick council report?

The Quick Council Issue Report is a general two-field report. This form asks the road-defect questions an inspector ranks by: size, depth and position in the lane.

Does reporting a pothole start a damage claim?

No. If damage has already happened, answer yes and describe it, and the report should be routed into your claims process as well as the repair queue.

Why ask about bus and cycle routes?

Because most authorities prioritise defects on those routes, and a resident can answer it far faster than a records lookup.

What if the road is a motorway or trunk road?

Those are often another authority's responsibility, so say which roads you maintain beside the form and where to send the rest.

Is the Pothole Report Form template free to use?

Yes. You can preview and test Pothole Report 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 Pothole Report Form template ask for?

It asks 15 questions across 1 page, 10 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 Pothole Report Form form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, 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 conditional validation: if “Has it already caused damage or injury?” is Yes, “What happened, and when?” becomes mandatory before the form can be sent. Features advanced show logic: if “Where is it?” is On the pavement or footpath, the form dynamically exposes “Is there room to walk around it?”. Otherwise that question never appears. Features advanced show logic: if “Roughly how deep is it?” is Deeper than a brick, the form dynamically exposes “Is there anything to warn drivers or cyclists?”. Otherwise that question never appears. All rules are editable in the Logic tab.

Where do responses to the Pothole Report 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 Pothole Report 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 pothole report form.

Related categories

All Government & Public Sector templates

Pothole Report Form

Searches this template answers

Also filed under