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2. This form may be used for first-time information as well as any updates.

   In order to facilitate prompt and safer response from the Police, Fire, Rescue, or EMS Departments in Calvert County, we kindly request your collaboration. If you possess SPECIAL NEEDS or have IMPORTANT INFORMATION that could aid emergency responders in reaching you or your family swiftly and securely, we encourage you to complete this form.

   Please include any special health conditions or considerations, as well as details regarding hazardous materials or situations. This crucial information will be logged into our computer-aided dispatch (CAD) system. When you contact Emergency Communications (911), your address will be entered into CAD, and the provided special information will be relayed to the responding agency by our dispatchers.

   Rest assured, all information is treated with utmost confidentiality and will only be shared with the emergency personnel dispatched to your location.

   Should you have any inquiries, feel free to reach out to Mrs. Morlock, the Audio & Data Entry Clerk, at 410-535-1600 ext. 2342, or Mrs. Denton at ext. 2352. Your cooperation ensures a more effective emergency response system for our community.

4. Requester Name*
6. Primary Phone Number*
7. Secondary Phone Number
11. Patients Name
12. Date of Birth
14. Address*
16. City*
17. State*
18. Zip*
19. Apt#
21. Special Information Needed For Emergency Dispatch*
23. This information will not be given out to the public.
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26. Email address

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