How Do I Report An Occurrence?

Please fill out and submit the form below. (Some fields are required.)  Your information is valuable to us so that we may help you and for the purpose of identifying areas for improvement. This form is the preferred method of reporting, but a special automated hotline has been set up for those without internet access. To report an issue by phone, call the hotline at: 812-256-7130.

Guest Information

1. Project Clean Lines Occurrence (Please choose all that apply, but only those that apply.)
2. Discolored Water Chlorine Odor Other
3. Your Name(required)
4. Street Address(required)
5. Email(valid email required)
6. Phone Number (If you choose to be contacted via text or voice call, please be sure to include your phone number.)
7. Should we need to contact you, which is your preference?
8. Email Phone Text Message
9. Date of Occurrence (mm/dd/yyyy - e.g. 02/01/2012)(required)
10. Time of Occurrence (hh:mm am/pm - e.g. 12:34 am)(required)
11. Has the same thing occurred before?
12. Yes No
13. If yes, when was the most recent, previous occurrence?
14. Please describe the occurrence.
15. Please add me to the CtownConnect Email list (check the box)

 

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