Voter Assistance Request Form

If you need assistance with voter registration or voting, please complete the form and someone will contact you back to make arrangements on the service you are requesting.

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.

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.

Last reviewed January 12, 2023

Voter Assistance Request Form

Related pages

Was this page helpful?