E-Gov Services City of West Richland

Complaint Form

WARNING! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. If your issue is an emergency, please use the telephone and dial 911.

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Purpose. This form is used to communicate complaints to City personnel.

* Information is required.

Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone:	() –
Fax:	() –
Address:
City:
State:
ZIP:

Nature of the complaint/suggestion...

If this complaint is directed to a specific department, please indicate which department.

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* Information is required.

Notes:

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Information we receive may be considered public information which is subject to disclosure under current state law.

Internal Use Only, Leave Blank:
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