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2. Form
   Goochland County understands that significant portions of the county are currently unserved or underserved by both broadband and cellular providers. Additionally, that our citizens encounter problems with their existing providers that they are unable to resolve through normal processes. This form is intended for citizens to use to share with Goochland County staff about their broadband and cellular needs/ issues.
4. Instructions
   Please use this form to share about broadband and cellular needs and issues. Before reporting provider issues, please follow the steps listed on the “Having a problem with a provider?” page. Link provided below. Submit information by email to Paul Drumwright by completing the form below or contacting Paul Drumwright at (804) 556-5833.
6. Having a problem with a provider?
   Link
8. First Name*
9. Last Name*
11. Phone Number*
13. Email address*
15. Address1*
17. Address2*
19. City*
20. State*
21. Zip*
23. Address of Need/Issue if Different
25. Address2
27. City
28. State
29. Zip
31. Provider Name
33. Help/Trouble Ticket # (Provided by your Provider)
34. Current Speed
36. Explanation of Issue
38. Send Pictures or Information
    Attach photos or documents.
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field