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2. Type of Complaint

   Select any that apply

   1. Blocked Pedestrian Access
   2. City Employment
   3. Communications Access
   4. Crosswalk

   1. Curb Ramp
   2. Parking
   3. Pedestrian Signal
   4. Protruding Hazard

   1. Transit
   2. Tripping Hazard
   3. Work Zone
4. Please Describe Your Complaint*
5. Location of Complaint
7. Is the complaint in the public right-of-way?

   1. Yes

   1. No
8. Do you have a reference for this complaint?
12. Name*
13. Email*
14. Phone*
16. Would you like to be contacted once resolved?

    1. Yes

    1. No
17. Preferred Method of Contact
    -- Select One --EmailPhone
19. Image Upload
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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