Silver Alert

Leave This Blank:

Six out of 10 people with dementia will wander, according to the Alzheimer’s Association. Anyone who has memory problems and is able to walk or drive is at risk. Even somebody in the early stages can become confused enough to get lost.

Please use this form to submit information about your loved one to the Denison Police Department.

All information is stored in a secure online database, and is only shared with emergency responders and medical facilities in the event of an emergency.

The information will provide emergency responders with a baseline from which to begin treatment, as well as the ability to contact personal physicians and loved ones in the event of a wandering incident or a medical emergency.

SILVER ALERT INFORMATION...

Convert to PDF?
(GIF, JPG, JPEG, PNG, DOC, DOCX, XLS, XLSX, TXT)
EMERGENCY CONTACT INFORMATION...
 
* indicates required fields.