Elgin County, St. Thomas, and Aylmer Emergency Services offer special assistance to residents with disabilities when an emergency occurs. Should you or a resident in your household require special assistance and would like to have your name and address placed on our Registry, please complete this form and return it to us. This will ensure in the event of an emergency situation, the responders are better equipped to assist you. This voluntary registry will provide the Police Services with emergency contact information, detailed physical descriptions, known routines and special needs of this individual. This information will assist officers in communicating with, attending a residence of, or dealing with an emergency involving this individual.

As the Parent/Guardian/Administrator/Substitute Decision Maker, or self-advocate, you will be requested to complete information regarding the individual you are registering.

Please have a recent photo of the person you are registering (alone, not a group picture) as a hardcopy and a .jpg attachment to the registration form.

The registry information must be updated every year.

A hard copy can be downloaded at the link below:
Vulnerable Persons Registry Application


Vulnerable Person Registry
Vulnerable Person Online Registration *
(for updates please include the name, DOB and then only new information)
Vulnerable Needs of Applicant *

Vulnerable Person Details

Upload Photo
Drop an JPEG image file here or click to upload Choose File
Maximum upload size: 5MB

Residential Address

Employment/Educational Address

Transportation

Family Physician

Physical Characteristics

Emergency Contacts

Registrant Information

Consent Agreement

 



Beard Approved LogoThis website has been Beard Approved by Redding Designs