Use this service to send feedback to the Department of Social Services. Please fill out the information below. Required fields are marked with an *. (Suffolk County will NOT sell your e-mail address nor use it for marketing purposes.)

 

* First Name:     

* Last Name:  

*Mailing Address Line 1:      

Mailing Address Line2:   

* City:      

* State:        * Zip 

* Daytime Phone: xxx-xxx-xxxx     

Email Address:  

Case/Application Number:  

* Service Area:    

Add subject when service area selected is "Other" :   

Message:      

Test - I Am Not A Robot

Please check the box to continue.