Report a local issue form with photo and location
Residents notice problems, and a simple way to report them gets more of them reported. This conversational form asks where the problem is, the type (pothole, lighting, litter, noise, graffiti or other), a description, an optional photo and an optional email for updates.
Who it is for
- Residents' associations and neighbourhood groups
- Local councils and community organisations
- Building managers and campus teams
When to use it
Share the link on a poster with a QR code, or in a group chat. Reporting takes under a minute, on the spot, with a photo taken on the phone. A clear location is the most important piece, so say in your introduction how to describe it.
What the form asks
Questions
- Where is the problem? · requiredShort text
- Type · requiredDropdown
- Describe it · requiredLong text
- Photo (PNG or JPEG)Image upload
- Email (for updates)Email
Every question can be changed, removed or reordered before you publish.
The PDF your respondents receive
Each report is a PDF with the photo and the description, ready to forward to the body that can fix the problem. A copy is kept in your list of responses.
Questions people ask
- Does it send the report to the council?
- No. It collects reports for you. You forward them to the right service, or file them yourself.
- Is the email required?
- No. It is optional, for people who want updates.
- What about photos with people in them?
- Ask reporters to avoid photographing identifiable people and number plates, and remove such images before sharing a report publicly.
Start from this template
Create an account, adapt the questions and the document to your business, then share the link. Your respondents get their PDF the moment they finish.