Special Assistance Information

Providing information about a disability or special needs can make a life or death difference. Do you utilize assistive medical devices such as oxygen, use a wheel chair, have a vision or hearing disability, register with a medical alert program, have a private well, or utilize other life support or assistive equipment? If so, we collect this information to help our local emergency services to prepare and respond to emergencies. Your participation in the “Special Assistance Registration Program” is voluntary. All information will be kept on file at the Bernardsville Police Department. Every attempt will be made to keep the information confidential. Information received will not be intentionally released to anyone other than emergency responders. To participate, take the survey found on the Police Department Website, or follow the link at http://bernardsvillepd.org/register or simply complete the form on the reverse side of this Brochure. Completed forms can be dropped off at police headquarters, sent via USPS, faxed, or emailed to: Bernardsville Police Department Office of Emergency Management 166 Mine Brook Road Bernardsville, NJ 07924. Fax: (908) 766-2084 Email: admin@bernardsvillepd.org