RESIDENTIAL SPECIAL NEEDS APPLICATION

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.  

If you want to print out the form to drop off, mail, or fax, click here. 

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.

If you have any questions, please feel free to contact the Office of Emergency Management at the above listed telephone number.

Sincerely,

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