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:     

Please check the box to continue.