Emergency Information Record
If you are a Halifax Senior and/or an individual with a disability that will require assistance in the event of an emergency evacuation or other emergency situation, please complete this form. The information provided will only be used by and shared with emergency and other authorized personnel. If you'd like to request more information or need to update to your record, please contact Darlene Regan, Council on Aging Director by calling (781) 293-7313 Ext. 135 or e-mail [email protected].