Residential Special Needs Assistance Form

Dear Resident,

The Borough of Fair Lawn Office of Emergency Management has established a Residential Special Needs Registry for citizens who may require special attention during times of emergency. If you or someone you know is using oxygen in their home, requires a walker to get around, is on kidney dialysis, or has any other form of physical or mental disability, please take a few moments to fill out this application.

Please be assured that all information is kept confidential and is distributed to the police, fire, rescue, ambulance, health, and public works departments for use during emergency.

Click Here to Download the Form: Special Needs Registry Form