311 Service Request Intake and Routing Form

Intake form for non-emergency 311 service requests to categorize the issue, route it to the responsible department, and track resolution timing.

Submission Notice

• Briefly describe your request
• This is a non-emergency request
  Check this box to confirm the issue is not an emergency and does not require immediate police, fire, or medical response.
• Would you like to be contacted about this request?

Requester Information

• Your name
• Email address
  Used for status updates and follow-up questions.
• Phone number
  Optional alternative contact method.

Location Details

• Location type
• Service location
• Additional location details

Request Classification

• Request category
• Priority
  Use the lowest priority that accurately reflects the impact.
• Responsible department
  Auto-routed based on the selected category.

Issue-Specific Details

• How many lights or signals are affected?
• Roadway issue type
• Water or drainage details
• Describe the issue

Supporting Information

• Upload photos
  Optional photos of the issue.
• Best time to contact you
• Additional notes

Routing and Resolution Tracking

• Request number
• Assigned team
• Status
• Date received
• Date resolved
• Resolution notes