Medina County Disability Registry: Law Enforcement Contact Form
The Medina County Board of Developmental Disabilities along with emergency response personnel in Medina County created this form in order to help improve response to calls involving individuals who may have a disability living in Medina County. Your response to this form is completely voluntary. If you chose to complete the form, this information will be made available to local emergency response personnel throughout Medina County which will be used to help ensure that dispatchers and emergency responders are aware in advance of any information you feel would be important to know about an individual with a disability living in your household. If you choose not to complete the form, the timeliness or quality of emergency response will not be affected. This form simply provides safety services with an advantage before they arrive on scene.
If you move or if the situation in the home changes, please contact your local law enforcement agency so they can make necessary adjustments in their respective alert systems.
Your answers to the following questions will assist deputies, fire or medical personnel when they are responding to an emergency or other call from your home. The information provided will help in identifying and/or assisting you or a person in your household who has a disability.