If you live, work or are visiting in Brentwood and have a problem or concern, you can fill out the following form and send it to us on the Internet. We will forward it to the appropriate City department for action.

 

What kind of comment would you like to send?

Complaint
Problem
Suggestion
Praise
Other

 

What about us do you want to comment on?


Other:



Date and Time

Please enter the date and time that the problem was noticed in the space below. 

Date:    Time:



Problem Noticed

Please select the problem noticed from the list below.

 



Details

Please enter any further details (such as street name) you may have on the problem that will help us identify where the problem is located or why it might be occurring.

 


Send The Form
Name and E-mail address required.
Please enter your name   
Please enter your email address   
Please enter your daytime phone number if we need more information

Enter the following word exactly as it appears: comment   


Please enter your name and address and then click the "Submit" button to send the form to City Hall for action.

We appreciate your help in keeping the City of Brentwood in top condition by sending us your comments on this form!

Please contact me as soon as possible regarding this matter.