Special Needs Registry

This program is designed for those who have special physical or medical needs that may require special assistance in the event of a major emergency or disaster. In the event of an actual emergency, response agencies will attempt to provide the necessary assistance but because of significantly increased demands on government resources this cannot always be assured. To best guarantee personal safety, individuals should take the necessary advanced precautions and follow planning guidance issued by governmental agencies.

Please register below or if you prefer you can print out the following pdf file:
Special Needs Registry

Personal Information

Application Type:
Residence Type:
Living Situation:

Medical Information

(Check & complete those that apply to your condition.)

Emergency Contact Information


I agree that my protected health information be added to the Special Needs Registry in the HC911 Dispatching Software. I give Huron County 9-1-1 authorization to share this information with other local support agencies in the event of a disaster or emergency. I also grant emergency response personnel permission to enter my home during search and rescue operations following a disaster or emergency, if necessary, to assure my safety and welfare. I hereby release and hold harmless Huron County and any first responders from and against any and all damages, losses, or costs (including reasonable attorney fees and defense costs) caused in whole or in part by your failure to provide correct or updated information relative to the Special Needs Registry.

Huron County EMA