Service Request Form
Fill out a Service Request form to report a physical barrier on a street, sidewalk, park, or other City-owned space. A barrier may include an impassable sidewalk, ramp, broken, inoperable, or substandard accessible facility on City streets or within City buildings.If you need reasonable accommodation to fill out the Service Request Form, please contact the City of Walla Walla ADA Coordinator at 509.527.4540 or TTY (7-1-1) at ada-titlevi@wallawallawa.gov.
Location of Issue
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Street Address
City
State / Province
Postal / Zip Code
Location Details
*
Upload a photo of the issue (optional):
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Description of Issue
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Name
*
First Name
Last Name
Would you prefer contact by phone or email?
*
Phone
Email
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Signature
*
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