Service Request

2. The City of Rock Island strives to provide excellent service to our citizens and businesses. This form can be used to submit questions, comments, or complaints. If this is an emergency or the complaint is about an activity in progress, please call 911. Use the following online form only for non-emergency situations.

   The City of Rock Island strives to provide excellent service to our citizens and businesses. This form can be used to submit questions, comments, or complaints. If this is an emergency or the complaint is about an activity in progress, please call 911. Use the following online form only for non-emergency situations.

4. If you would like to report a crime or drug activity please use the <a href=" /FormCenter/Request-Tracker-Forms-5/Police-Report-a-Complaint-48"><font color="22407b" <u> Police Report a Complaint </u> </font> </a> or if you would like to report graffiti/trash/weeds/vacant properties please use the <a href=" /FormCenter/Request-Tracker-Forms-5/Inspections-Report-a-Problem-47"><font color="22407b" <u> Inspections Report a Problem </u> </font> </a>.

   If you would like to report a crime or drug activity please use the Police Report a Complaint or if you would like to report graffiti/trash/weeds/vacant properties please use the Inspections Report a Problem .

6. For all other service requests please submit your information below. Please remember online submissions will take time to process and are forwarded to the appropriate department for follow-up.

   For all other service requests please submit your information below. Please remember online submissions will take time to process and are forwarded to the appropriate department for follow-up.

8. Request Information

10. Request Type:*
    -- Select One --Adult ProgramsBoards & CommissionsBusinessCity ClerkCity CouncilCity ManagerFinancesFire & AmbulanceFitness Center (RIFAC)GolfHistoric PreservationHousing ProgramsMartin Luther King CenterMayorOther/MiscellaneousNeighborhoodsPark LocationsParkingPermits, License, & InspectionsPoliceProperty NuisanceRefuse, Recycling & YardwasteStreets & SidewalksSunset MarinaWater, Sewer, & StormwaterWhitewater Junction PoolYouth ProgramsZoning & Land Use

11. Follow Up By:*
    -- Select One --EmailLetterNo Follow UpPhone

13. Request:*

15. Contact Information (*Required for Street & Sidewalk Requests)

17. Name:

18. Address:

20. Phone:

21. City:

23. Email:

24. State:

25. Zip Code:

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

* indicates a required field