Approved by OMB 3060-0874 (Est. average burden per response is 15 minutes). Read Privacy Statement

If you would like to share your experience, please complete this form. In the description field, you can provide specific details about your experience , including the name of the provider, your address and any other information that describes the challenges that you have experienced, including those due to a provider’s practices and polices related to certain terms and conditions of service, such as those concerning speeds, data caps, throttling, late fees, equipment rentals and installation, contract renewal or termination, customer credit or account history, promotional rates, price or how technical support is provided.

By sharing their broadband access stories, consumers will help the FCC to identify barriers experienced by historically unserved and underserved communities and inform the work of the Task Force.

Fields marked with * are required. The submit button will not be active until all required fields are completed.

Web browsers supported: Latest two versions of: Chrome, Firefox, Safari, and Edge.

The format of the zip code can be: 20850 or 20850-1234

Please enter the phone number in the following format 555-555-5555

Your description is important to understanding your situation. Do not include any sensitive information, such as SSN, DOB, driver's license numbers, medical history, etc.

Add file or drop files here