Fix It Form

2. The City of Siloam Springs FixiT Form will help us identify a problem in your area -- and fix it fast. Should a problem require urgent attention, please call us immediately. For a police emergency, dial 911. Otherwise, call 479-238-0927
   Thank you for your assistance!

   Thank you for your assistance!

4. Contact Information

6. First Name*

7. Last Name*

9. Address1

11. Address2

13. City

14. State

15. Zip

17. Phone Number*

18. Email Address*

20. What ward are you in?
    Ward Map

    Please choose what ward you live in.

21. Choose your ward
    -- Select One --Ward 1 (northwest)Ward 2 (northeast)Ward 3 (southeast)Ward 4 (southwest)I am a visitor to Siloam Springs

23. 1. Pothole
    2. Damaged curb
    3. Traffic signals
    4. Weeds
    5. Dogs barking
    6. Abandoned vehicles
    7. Chemical discharge

    1. Water leaking
    2. Litter
    3. Road striping
    4. ADA Complaint
    5. Blocked drainage channel
    6. Street Lights
    7. Damaged sidewalk

    1. Traffic/Road signs
    2. Overhanging trees/shrubs
    3. Noise nuisance
    4. Hazardous parking
    5. Storm sewer leaking/blockage
    6. Water leaking on roadway
    7. Loose/protruding manhole cover
25. Brief Description (or other problem not listed)

27. Location of Problem

    Please list address as needed

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field