SPECIAL NEEDS FORM (English) rev 9-15-23
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| Pages | 1 |
|---|---|
| File Size | 0.6 MB |
| Folder | Departments/Emergency Management |
| OCR Status | Searchable (OCR processed) |
| Source URL | Original |
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Do you have special needs that would require help in an emergency or evacuation? If “yes”, please fill out the survey below. Please complete and return yearly or if your situation changes. Check the New Survey box below if this is the first time you are completing this survey or haven’t done so in years. When special assistance is no longer needed, please email wem@ waterfordct.org. When completed you can either: email it to wem@waterfordct.org; mail to 204 Boston Post Road, Waterford, CT 06385, or drop off at the Waterford Senior Center. Waterford Emergency Management 204 Boston Post Road Waterford , CT 06385 860-442-9585 Follow us on Facebook