Alzheimer’s Registration FormAlzheimer’s Registration Form

Alzheimer’s Registration Form

  • Person Being Registered

  • Photos of Person Being Registered

  • Accepted file types: jpg, gif, png.
  • Accepted file types: jpg, gif, png.
  • Care Giver / Contact Information

  • Primary Contact Person

  • Additional Contact (1)

  • Additional Contact (2)

  • Other Information

  • Release

    I, the undersigned, for myself and the registrant named above do hereby authorize the Katy Police Department to release the aforementioned information in response to Emergency Calls (includes Missing Person incidents) regarding the registrant and do further agree to indemnify and hold harmless the Katy Police Department and persons (placed) associated with it.
Print Friendly, PDF & Email