Service Request Form

2. The City of Wadsworth is here to serve you. If you have a specific request that needs addressing by the City, you may use this form to contact the appropriate City department. Requests will be processed from 8 a.m. to 5 p.m. Monday through Friday. 

   If this is an emergency, please call 911 immediately. 

   If you would like to request assistance with more than one issue, please submit each request separately so that we may send each one to the appropriate department. 

4. Date of Incident:*
   Date of Incident:
6. Select the problem you would like addressed: *

   1. Abandoned or Illegally Parked Vehicle
   2. Damage to City Property
   3. Mailbox Damaged by Snow Removal
   4. Missing/Damaged Sign
   5. Overgrown Grass/Weeds
   6. Potholes
   7. Property Maintenance Issue
   8. Road Construction
   9. Sidewalk Issue
   10. Snow Removal

   1. Street Flooding
   2. Street Sweeping
   3. Streetlight Out
   4. Traffic Concern
   5. Utility Bills
   6. Vacation House Watch
   7. Vandalism/Graffiti
   8. Website Feedback
   9. Yard Waste
   10. Other
8. Please describe the problem:
12. Exact Location of Job Requested:
14. House #
15. Street Name*
16. Cross Street Name
18. Additional description of location, if needed.
22. Please provide the following contact information. At a minimum, an email address or phone number is needed.
24. First Name
25. Last Name
27. Phone Number
28. Email Address
32. Upload a File
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field