Emergency Responder Notification Forms
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.
Click a county to find more info
Data by County
Website (Functional Needs Information Form)
Website (Register with 911- ADA Application Form)
|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|