Form Center

Contact Jefferson County Online Form

2. Disclaimer

   Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at www.jeffco.us/privacy. By submitting this form, you acknowledge and accept the terms listed in the privacy policy.

4. Jefferson County Online Contact Form
   To contact Jefferson County by email, please complete the online form provided below. We welcome your questions, comments and suggestions. Responses are provided during business hours. Please visit departments and offices' pages for their hours of operation (www.jeffco.us/221).
6. Name*
8. Email*
   Please provide a valid email address. All personal information is kept private and used on our end to better assist you.
9. Phone Number
11. Do you think you have a website technical or ADA/accessibility issue?
    -- Select One --Broken feature/functionSlow page loadsBroken linkWebsite Americans with Disability Act (ADA)/accessibility issuesContent Issue - Can't find somethingOther (may take longer to address)

    Please only select this drop down if you feel you are experiencing one of these issues on the website, otherwise it may take additional time to address.
13. Comments or Questions*
Leave This Blank:


15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit

* indicates a required field