Submit Senior Information and Assistance Request Request


Reporter (leave blank to submit anonymously)

Enter as 999-999-9999

Senior Information and Assistance Request

This service request is used to request information and assistance from FSS-Senior Services. If a Senior needs the immediate assistance of Police, Fire or Emergency Medical services, please call 911.

Instructions

Describe the issue you wish to report including a photo and/or a description.
* Indicates a required field.