Voter Assistance Request Form

If you need assistance with voter registration or voting, please complete this form.

A Multnomah County staff member will contact you to make arrangements on the service you are requesting.

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Contact Information

First Name *

Last Name: *

Contact Phone *

Residence Address:

City

State

Zip Code

E-Mail

Preferred Contact Method Options *

E-Mail

Phone

Best time to contact you using your preferred contact method *

Morning 8am-12pm

Afternoon 12-4pm

Evening 4-8pm

Additional Information to help us contact you.

Location

I need assistance at...

Multnomah County Elections Office (1040 SE Morrison St. Portland, OR 97214)

Voting Center Express (600 NE 8th Street, Gresham, OR 97030 - open two weeks before election day)

Other

**We can provide assistant at your residence or any location that is convenient for you.

Service Request

Select all services that apply to your needs

I would like to vote privately and independently with a computer/tablet provided by the county

My signature is inconsistent and I need help completing an attestation form

I need a ballot brought to me

I need assistance turning in my ballot

I need assistance in a language other than English

I need assistance to register or update my registration

I need assistance reading and completing my ballot

Other

If the service you need was not listed above, you can provide details here.

Comments/Notes

If you would like to provide additional details, you can provide it below.

Leave this field blank

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