Last Name
City
Weight
Sex
State
Attachments
Begin typing Address and select from the populated drop-down
Eye Color
Address
First Name
City
Phone #
Name
Emergency Contact Information
State
Information
Email
Address 2
ZIP
Special Needs Services Information
Email
Please enter specifics such as any sensitivities, medications, places they frequent, topics to easily discuss to put individual at ease.
Phone #
Additional Comments
{[PNAME]}
Medical Condition
Phone #
Date of Birth
Hair Color
Email
Height
Address 2
Address
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
ZIP
Please attach a current photo of the individual for identification purposes
First Name
Address 2
Race
Address
Additional Emergency Contact Information (Optional)
ZIP
Last Name
The Englewood Police Department is seeking voluntary emergency contact information for any person (of any age) that are affected by any form of altered mental status including Autism, Dementia, Bi-Polar Disorder, Schizophrenia, or other illness, condition, or “Special Need” that may cause them to become impaired.

Police Officers receive specific training to follow protocols when they contact persons with “Special Needs”. It would greatly help if The Englewood Police Department was able to understand who the person is prior to making contact. This prior knowledge will aid in better communication which will lead to a safer resolution for all involved parties.

*This information is solely entered in our computer system. It is intended for information purposes only and will not be shared.*

The Englewood Police Department can enter specifics such as:

  • Noise, Sound, Touch sensitivities
  • Medication they may be taking
  • Places they frequent
  • Topics to easily discuss to put the individual at ease

    • Furthermore, after the individual’s needs are registered (see form below), they will be provided with an Identification Card, which if kept on their person, can assist an Officer in identifying the individual or contacting a family member/guardian.

    City
    State
    Last Name