Please enable JavaScript in your browser to complete this form. - Step 1 of 2Name *FirstLastPhone number *Service address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs this outage due to infrastructure damage? *YesNoI'm not sureNextType of service *Click to selectFiberWidebandLTEI'm not sureProblem experienced *Click to selectNo connectivity - complete outageIntermittent outagesDegraded performanceOtherPlease describe the problem *Please describe the damage *Do you know the party responsible for causing damage? *YesNoName of responsible party *Phone number of responsible party *Was an 811 Locate Request submitted for this location? *YesNoI don't knowEnter Locate Request Ticket Number *Please attach any photos of worksite and damaged infrastructure Click or drag files to this area to upload. You can upload up to 5 files. Additional comments (optional)Checkboxes *By clicking "Submit" I agree to receive emails, text messages, and phone calls, I also agree to the Terms of Use and Privacy Policy at https://nexstream.net/legal-information/. Reply STOP for STOP and HELP for help for more information. Message & data rates may apply. Message frequency varies.Data collected will NEVER be shared with third parties for marketing, advertisement, or any other purposes. View our Privacy Policy and other legal documents here. Submit
