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Roanoke County Citizen Response Service

Citizen Response Service Request Form

Use this form to report neighborhood problems, get information about county services, register complaints, make inquiries, or even pay us a compliment. When you report a problem, we notify the appropriate department to provide assistance. Then we keep track of your request until you get the service you need.  If you have further questions, please call 540-387-6200.

Caller Information
Anonymous:
First name:
Last name:
Email address:
Organization Name:
Home phone:
Work phone:
Fax phone:
Mobile phone:
Street number:
Street name:
Unit number:
City name:
State name:
Country:
Zip:
Case Information
Incident title:

 

Incident description:

 

Additional Information
Attachment: