Quality of Life Form
Broadmoor residents are encouraged to use this form to submit Quality of Life issues. The BIA will work to advocate to the city on your behalf.
Address Number (of Issue) *
Your answer
Street Name (of issue) *
Your answer
City of New Orleans 311 Case # *
All reported issues must be recorded with 311 before the BIA is able to intervene. This helps BIA track issues through city enforcement agencies. The number should be in the form of (XXXXXX). If you did not record your assigned case number, please contact 311 and record your case number.
Your answer
Issue Type *
Please select from the options below
Required
Please describe the issue(s) with as much detail as possible
Your answer
Reporter's FIRST NAME *
Your answer
Reporter's LAST NAME *
Your answer
Reporter's DATE OF BIRTH *
Date of birth is only used for internal data collection and reporting.
MM
/
DD
/
YYYY
CONFIDENTIAL
Check this box if you have provided your name but request to remain anonymous (for any reason). The BIA does not disclose those who report issues in our neighborhood. Your name is only required so that we can report back to you about your issue.
Email address *
Please provide an email address so that we can contact you regarding your issue. If you do not have an email address please write n/a and provide a working contact number below.
Your answer
Phone number *
Your answer
Address Number (of reporter)
This is not required but is helpful to our organization. Your information will not be shared.
Your answer
Street Name (of reporter)
Your answer
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