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Free form template

Form to report an issue on the road or in a public space

Reports come by phone, email, at the counter or on social media, and some get lost. With this form, every report lands in one place, with the type of issue, the exact location and the urgency.

Use this template

6 fields · Free to start, no credit card.

Preview

Public space issue report

Report a problem in a public space: pothole, broken street light, rubbish, damaged equipment.

If someone is in danger, call the emergency services first.

Optional: to be told when the issue is dealt with.

What the template contains

  • Type of issue Dropdown · Required

    Required: the type of issue, to send it to the right department.

  • Exact location Text · Required

    Required: the address, the street corner or a landmark.

  • Describe the issue Long text · Required

    Required: what the person saw.

  • Is there an immediate danger? Radio buttons · Required

    Required: an immediate danger is handled first. The hint reminds people to call the emergency services if someone is in danger.

  • Your name Text

    Optional: people can report without giving their name.

  • Email Email

    Optional: to let the resident know when the issue is fixed.

Every field can be renamed, moved, removed or made optional in the editor, and you can add your own.

Handle reports

Each report lands in your account with its date and time. Search finds a street or a type of issue, and the CSV export lets you track interventions in a spreadsheet.

When a resident left their email, reply once the issue is fixed: that is what makes people report again next time.

Make it known

Put the link on the town website and in the local newsletter, and display the QR code on notice boards. The form opens on a phone, with no account and no app.

You get an email alert for each report, a few a day on the Free plan and then a daily digest. With a paid plan, alerts have no daily limit and residents can attach a photo with the File field.

Personal data: the right habits

  • Name and email are optional: do not make them required.
  • State in the description who handles reports, what the name and email are used for, and how long they are kept.
  • A single response cannot be deleted, only the whole form. For a public body, reports are public records: export them to CSV and keep them according to your records rules before deleting an old form.
  • Responses are hosted in France, with OVHcloud.

FAQ

Questions about this template

Can the form locate the issue on a map?

No: the place is described in text, with an address or a landmark. For places that are hard to describe, ask for a map link in the description.

Can it be used for emergencies?

No. Nobody watches the form around the clock: for an immediate danger, people must call the emergency services. The danger question helps handle those reports first.

Is the template free?

Yes. It only uses fields available on the Free plan, and every question can be edited, moved or deleted.

Start from this template

Edit it in a few minutes, share the link, read the responses in one place. Hosted in France, with OVHcloud.

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