Special Needs Registration

Welcome to the Ford-Iroquois Public Health Department All-Hazards Public Health Disaster Preparedness web site. We are dedicated to protecting the health and safety of the residents of our communities.

The Ford-Iroquois Public Health Department has a critically important role in public health disaster preparedness and response that includes response planning, surveillance, and early detection of communicable disease, laboratory support, emergency communication, training, and education.

During a disaster, our state and national governments alone cannot be the only one to respond. We will need resources and expertise from our local businesses and community members. Individuals and local businesses do heroic things in times of crisis, but they could do so much more working in concert with government. The Ford-Iroquois Public Health Department has created a registry for persons of special needs populations that will require extended and additional patient resources or equipment that normally would be unavailable to be called upon by an emergency manager in a catastrophic event. If you are homebound, speech or hearing impaired, medical dependent on equipment or medications, or a person of impairment in any other way, please complete the Ford-Iroquois Public Health Department’s online emergency response special needs registry so we can be prepared to locate you and provide for the items you need to accomplish your normal day-to-day activities.

If you prefer to print and mail-in your registration, you can do so here.

Two nearest (physical proximity) friend or relative (include their contact information) or personal caregiver
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