9-1-1 Disability Indicator Program

The disability indicator program is voluntary for both the community and it's residents. The disability indicator form  was created by a group of several different organizations representing the mobility, hearing, speech and sight impaired communities

The information provided on the disability indicator form enables a special code to appear on the 911 call takers screen which alerts the call taker that a person residing at that address may require special assistance during an emergency

It is a standardized form created to encourage participation from all persons with disabilities. As you are aware, there are an extensive range of disabilities and medical conditions. The disability indicator categories listed on the form may be considered too broad for some; when you consider the extensive range of disabilities. However, information requested on the form must remain sensitive to those who may not wish to provide detailed information.

Always remember information on the disability indicator form is confidential.

The disability indicator form is available through the State 911 Department or it can be downloaded from this website.  The new disability indicator procedure form  only requires that when a person in your community submits a signed disability indicator form, the 911 Municipal Coordinator signs the form and faxes it to the Verizon Database Center at 1 800 839 6020 for entry into the 911 Verizon database.
Annually, Verizon will send the Municipal Coordinator a current listing of those persons in their community who are enrolled in the disability indicator program for updating. Verizon enters the new information into the 911 database.

A new Disability Indicator Form should be submitted for the following:

1. A person moves or no longer resides at that address

2. The apartment number changes

3. The telephone number changes

4. To add or delete a disability

Disability Indicator Form

Disability Indicator Form - Large Print

Disability Indicator Program for 9-1-1

Are you or a loved one physically, mentally, visually, or hearing impaired? Is someone in your home in a wheelchair or can't speak? If you answered yes to any of these questions, then we should know about it. The E-911 Disability Indicator Form will allow us to know if someone in your home is impaired.

Please return the completed form to Dennis Leclerc at the Seekonk Police Dept. to complete the process.