The Brunswick Safety Departments have created this form specifically designed to help us improve our response to calls with the residents of our city who may have a disability. Please complete the voluntary questionnaire and either drop it off at the Brunswick Division of Police or email it to policerecords@brunswick.oh.us.

The form can be found by clicking here, or through the How we can help/FAQ submenu in the Police section of our website.

If you choose to respond, the information will be submitted into the Brunswick Emergency Dispatch CAD system for use by the Brunswick dispatch team. The purpose of the form is to ensure that dispatchers and emergency response personnel are aware, in advance, of any information you feel they would need to know about people with disabilities in your household in the event of an emergency. Responding to this questionnaire is completely voluntary. You may choose to respond on behalf of all of your household members or only certain household members. If you choose to respond, please be sure to provide your signature on the last page. Your signature gives us the permission we need to process this information, without it, the information cannot be processed. If you choose not to complete the form, the timeliness or quality of emergency response will not be affected. This form simply provides our safety services with an advantage before they arrive on scene.

We ask that if you move, or the situation in the home changes, please contact us so we can make the necessary adjustments in our alert system.