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2. First Name
3. Last Name
5. Would you like us to follow up with you?*

   1. Yes
   2. No
7. Phone Number
8. Email
10. Address or location of the street tree(s) you are reporting*
12. When did you observe this issue?*
    When did you observe this issue?
14. What type of concern are you reporting? *

    1. Dead street tree(s)
    2. Diseased street tree(s)
    3. Other
16. If other, please explain
18. Is more than one tree affected?

    1. Yes
    2. No
19. Species of affected tree(s)?
21. Please describe in detail the concern you are reporting.*
23. Upload Photo if applicable
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25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit Submit and Print

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