Functional Needs Registry

The information gathered from completion of this form will be used to alert public safety responders (police, fire and EMS) that an individual residing at this address has a disability that may hinder evacuation or transport. This will also notify them of premise information such as storm shelters, lock boxes, hidden keys, etc. This information is confidential and will appear on the telecommunicators computer screen only when this address is used.

To complete this form, please click HERE.

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