Use this form to file a claim against the City of Rockville (City), and our insurer the Local Government Insurance Trust (LGIT),if you... More… Use this form to file a claim against the City of Rockville (City), and our insurer the Local Government Insurance Trust (LGIT),if you believe the City should be legally liable for damage caused to your vehicle or personal injury resulting from an automobile accident. The City will accept this form as meeting the notice provision Section 5-304(b) of the Maryland Local Government Tort Claims Act (LGTCA). Upon submitting your form, the City's Risk Management Division will file a claim through LGIT and will email you with your individual claim number and the adjusters contact information. LGIT will handle all aspects of the management of your claim on behalf of the City, and will make all determinations regarding the acceptance or denial of any claims for damages. Less…
Use this form to file reports to the City's Safety & Risk Management Division for the following types of incidents: vehicle accident... More… Use this form to file reports to the City's Safety & Risk Management Division for the following types of incidents: vehicle accident involving City-owned vehicle, property damage to City property, graffiti, City tree falling down and damaging property, reports of uneven sidewalks, potholes, other public safety hazards, etc. Less…
Use this form to file a claim against the City of Rockville (City), and our insurer the Local Government Insurance Trust (LGIT), if you... More… Use this form to file a claim against the City of Rockville (City), and our insurer the Local Government Insurance Trust (LGIT), if you believe the City should be legally liable for damage caused to your residence resulting from a sewer backup originating from City maintained sewer lines. The City will accept this form as meeting the notice provision Section 5-304(b) of the Maryland Local Government Tort Claims Act (LGTCA). Upon submitting your form, the City's Risk Management Division will file a claim through LGIT and will email you with your individual claim number and the adjusters contact information. LGIT will handle all aspects of the management of your claim on behalf of the City and will make all determinations regarding the acceptance or denial of any claims for damages. Less…
Use this form to file a claim against the City of Rockville (City), and our insurer(s),if you believe the City should be legally liable... More… Use this form to file a claim against the City of Rockville (City), and our insurer(s),if you believe the City should be legally liable for damages caused to you or your property. The City will accept this form as meeting the notice provision Section 5-304(b) of the Maryland Local Government Tort Claims Act (LGTCA). Upon submitting your form, the City's Risk Management Division will file a claim through our insurer and will email you with your individual claim number and the adjusters contact information. The City's insurer(s) will handle all aspects of the management of your claim on behalf of the City, and will make all determinations regarding the acceptance or denial of any claims for damages. Less…
Use this form to report any property maintenance violations you observe from the public right-of-way. The information you provide will... More… Use this form to report any property maintenance violations you observe from the public right-of-way. The information you provide will help the Rockville City Police Department successfully respond to any property maintenance concerns in your community. Please be observant and complete as much of the form as possible. See the list of violation types below to help determine which category of violation to report. The information you submit will be investigated, and if the offense is identified, every effort will be made to ensure the corrections are completed. Rockville City Housing code Inspectors may contact you for additional information if you elect to provide your name in the space provided below. Thank you for helping us help you.Less…
Building and Fire Code Complaint Form
Complete this form to request assistance with Landlord/Tenant inquiries. The office can assist in such matters as security deposit... More… Complete this form to request assistance with Landlord/Tenant inquiries. The office can assist in such matters as security deposit resolution, rent issues, repair requests and lease termination issues. The City will advocate for the Tenant or Landlord in an effort to reach a fair and equitable resolution.Less…
Authorization of Services for Patriot Urgent Care
Authorization of Services for Concentra Urgent Care
Use this form to consent to, or decline, the vaccination series for Hepatitis B. The Occupational Safety and Health Administration... More… Use this form to consent to, or decline, the vaccination series for Hepatitis B. The Occupational Safety and Health Administration (OSHA) requires employers to offer the vaccination series for Hepatitis B (HBV) free to all employees who might be exposed to blood or other potentially infectious materials as part of their job duties. This vaccination is voluntary. If you have received the HBV vaccination within the last 20 years, you do not have to have the series performed again. If it has been more than 20 years since your last HBV vaccination, you may need a booster vaccine. Please select one of three options on this form to confirm that you have either received the HBV vaccination previously, you wish to decline the HBV vaccine, or that you consent to having a HBV vaccine performed at the City's preferred occupational medical facility at no cost to the employee. Less…
Pre-Registration Application for Fingerprinting
To report a missed collection.
If you live in Rockville and have a request, problem or comment concerning traffic, transportation or street lights, please send your... More… If you live in Rockville and have a request, problem or comment concerning traffic, transportation or street lights, please send your information to us. The Service Request Coordinator will assign responsibility for your concern to the appropriate staff for action. If your problem or question is date/time specific, please enter below and include a.m. or p.m.Less…
Please use the form below to report any specific concerns regarding vacuum leaf collection, keeping in mind that we have a full... More… Please use the form below to report any specific concerns regarding vacuum leaf collection, keeping in mind that we have a full schedule, and your neighborhood deserves our undivided attention during your scheduled week.Less…
Let us know what questions you may have about Rockville Recreation and Parks.
If you live in the City of Rockville corporate limits and have a request, problem or comment concerning park or facility (other than a... More… If you live in the City of Rockville corporate limits and have a request, problem or comment concerning park or facility (other than a tree problem), please send your information to us using this online form. The Parks and Facilities administrative staff will assign responsibility for your concern to the appropriate staff for action. If this is an emergency request, please call 240-314-8700 between the hours of 7 a.m. - 3 p.m.; Monday - Friday. If the emergency is after hours call the City Police Department at 240-314-8900. Please note: All routine requests will be prioritized and handled in an appropriate, timely manner.Less…
If you can help a senior neighbor out this Winter please fill out the form below. Thank you for your time!
This form is used to check references for applicant eligibility to work with summer playground programs.
Glenview Mansion, F. Scott Fitzgerald Theatre & Social Hall
If you live in the City of Rockville corporate limits and have a request, problem or comment concerning street trees or park trees,... More… If you live in the City of Rockville corporate limits and have a request, problem or comment concerning street trees or park trees, please send your information to us. The Service Request Coordinator will assign responsibility for your concern to the appropriate staff for action. Please note: requests for routine maintenance such as the pruning of low limbs may take up to 6 months to be completed. For requests concerning tree limbs in electric wires, residents should call Pepco Customer Service at 202-833-7500 and say the word "Agent" when prompted, to request a tree trim. Tree Emergencies: Issues with live wires down, or other life and death emergencies involving Pepco wires, call PEPCO directly at 1-877-737-2662. For fallen trees blocking the road call 240-314-8700 during normal business hours. If there is no answer or if the call is after normal business hours, call the police dispatch at 240-314-8900.Less…
This form is used to check references for applicant eligibility to work with summer camps.
Please take a moment to let us know what you thought of your class. Your feedback is important to us.