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Sudbury Voluntary Registry Form

In the event of an emergency in Sudbury, you may need to care for yourself for up to 72 hours, even if the electric power fails. The Town is making plans to help its residents in case of a serious emergency, but it is important for everyone to be prepared to help themselves.

Some people may need or want special help planning for themselves, or might need special assistance if they should have to be evacuated to a shelter. It will help our ΓÇ£first respondersΓÇ¥ (police and fire personnel, the CitizensΓÇÖ Emergency Response Team and the Medical Reserve Corp) to be aware of the location and needs of people with these special circumstances.

If you are such a person (or are the caregiver for one), you can join a voluntary registry that will help local authorities be aware of your special needs. This information will be kept confidential to the extent required by law. The Sudbury Public Health Nurse will call you to provide additional planning assistance.

Please fill out the Sudbury Voluntary Registry form below and then submit. If you would like to print your application, print the completed form before you submit the application. Thank you for your input!

PARTICIPANT INFORMATION

If you would need special help in an emergency, you may wish to fill out and return this form so that you can receive assistance developing an action plan for your personal safety.* This information will be kept confidential by local authorities to the extent required by law. The Sudbury Public Health nurse will call you to provide additional planning assistance.
*Please be aware that the Sudbury Fire department and other Town departments are committed to providing assistance in emergencies, but depending on the nature of the emergency and its duration it may not be possible to provide immediate assistance with evacuation. For this reason it is important that all citizens make plans and preparations to care for themselves.