Skip to form

Town of West Hartford

NoReply@WestHartfordCT.GOV

50 S Main, West Hartford, CT, 06107, US

860-561-7500

Special Needs Registry

The Town of West Hartford Special Needs Registry is a voluntary program that allows residents with health or medical issues to alert the Town of their situation. It is designed to assist in alerting emergency responders to individuals with health and medical conditions that may require assistance during an emergency situation.The information contained in this data base will also be used for planning purposes to better prepare the Town for natural and manmade disasters.

Disclaimer:

In an emergency or disaster, police, fire, and other responders might not be able to access your information.The Registry in no way replaces the responsibility of individuals to have their own emergency plans in place. Participating in the Registry does not shift any responsibility from the individual to the Town. More information on making an emergency planning can be found at www.ready.gov.The Registry is a voluntary program and in no way ensures that the individual enrolling in the program will receive immediate or preferential treatment in an emergency. This registry does not guarantee any service from the Town of West Hartford.

Today's Date

Date Picker

Is this a new or updated registry form?

Full Name

Full Address

Do you live in an apartment?

If you wish to designate someone other than yourself as a contact person when the list is updated (annually) please give their name and telephone number:

Contact's Full Name

Contact's Full Address

Please be sure to notify the Fire Department if there is any change in your status.