Emergency Responder Notification Forms
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Overview
Many counties throughout Pennsylvania have created a form to notify emergency responders that individuals on the autism spectrum, or with other diagnoses or needs, live at a particular address. It is important for emergency responders to be made aware of who lives in the home, any sensitivities than the autistic individual may have, and the types of behavior the responders may witness so they are better prepared to safely handle a potential emergency situation.
Below we have included links to these forms in the counties where they are available. In counties where a form is not available, the website of the county emergency management agency or local public safety office is listed. You can reach out to these offices to learn more about the services they offer and may be able to notify the emergency responders in your area about autistic individuals that may be living at a particular address. Please check back regularly for updates on emergency notification forms.
County Forms
Click a county to find more info
Data by County
Adams County
Allegheny County
Armstrong County
Beaver County
Bedford County
Berks County
Blair County
Bradford County
Bucks County
Butler County
Cambria County
Cameron County
Carbon County
Centre County
Chester County
Clarion County
Clearfield County
Clinton County
Columbia County
Crawford County
Cumberland County
Dauphin County
Delaware County
Elk County
Erie County
Fayette County
Forest County
Franklin County
Website (Functional Needs Information Form)
Fulton County
Greene County
Huntingdon County
Indiana County
Jefferson County
Juniata County
Lackawanna County
Lancaster County
Lawrence County
Lebanon County
Lehigh County
Luzerne County
Lycoming County
McKean County
Mercer County
Mifflin County
Monroe County
Montgomery County
Montour County
Northampton County
Northumberland County
Perry County
Philadelphia County
Website (Register with 911- ADA Application Form)
Pike County
Potter County
Schuylkill County
Snyder County
Somerset County
Sullivan County
Susquehanna County
Tioga County
Union County
Venango County
Warren County
Washington County
Wayne County
Westmoreland County
Wyoming County
York County
Other downloads
| Name | Description | Type | File |
|---|---|---|---|
| Social Story- Premise History Form for Emergencies | Social story that explains how premise history forms can be useful in emergency situations. | Download file: Social Story- Premise History Form for Emergencies | |
| The Importance of Completing a Premise History Form | This resource provides information on the importance of completing a Premise History Form and what should be included to keep you or a loved one in your family safe in the event of an emergency. | Download file: The Importance of Completing a Premise History Form |