Texarkana-Bowie County Family Health Center

Healthy People in Healthy Communities


Environmental Health Section - Vector Control

902 W. 12th
Texarkana, Texas 75501



Directions:

This form is only for location within the City of Texarkana, Texas. Enter all information requested below by typing in the available spaces. Use the Tab button to move from box to box or use your mouse to point and click. Use your Space Bar or mouse clicks to make checks within the boxes. After all of the information is entered, use the Submit button at the bottom of the form to submit the Standing Water Monitoring Report form. Note: If when you hit the "Submit" button you recieve a message dealing with your browser trying to send a message be sure to click yes so that the form will be sent.

Service Request Form
(Only for the City of Texarkana, Texas)
Your Name:
 Your Address:
Day Phone:
 Evening Phone:
Email Address:
 Address of problem:
Type of service/s requested:

Mosquitoes
Rats
Nuisance complaint
Other

Description of problem:




Confidentiality Policy

Information that you give us is confidential, so we will not reveal the source of a complaint. It is important that you give us your name, phone number and address so that the City of Texarkana, Texas Vector Control can contact you for the following reasons: