City of Long Beach, CA - Service Request

How Can We Help You?

Please use this form to make a city service request, comment on an agenda item, ask for additional information about a city program or service, share your comments, or pose a question.

Please select one:*
Service Request
Council Agenda Item
Request for Information
Comments and Questions

If you selected "Service Request", select the type of service you need from the list.
(Hold the CTRL-key down while clicking to select multiple items)

Describe the service or information needed:*


If you have spoken or written to the City already on this matter, please provide those details:

Please provide your contact information, should we need to reach you regarding your request.

Title
First Name *
Middle
Last *
Daytime Phone *
Ext
Evening Phone
Fax
Address *

City *
State *
Zip *

Email Address *

Confirm your Email Address *

* required field