Access and Functional Needs Registry - Personal

Personal information
Additional information

Medical Conditions:

Check any that apply

Vision level
Check any that apply
Level of mobility
Frequency
Language
Submitter Acknowledgement
Signing up for this registry does not guarantee priority response or services of any kind. The signer also acknowledges that there is no substitute for personal emergency preparedness. In a disaster, government and other agencies will be very busy, and may not be able to meet your needs immediately. It is important for all residents to make individual plans and preparations for their care and safety in an emergency.
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